Can financial incentives encourage women to participate in a cervical cancer screening programme? Evidence from a randomized controlled trial analysis

Background: The incidence of cervical cancer can be reduced by introducing effective screening programmes to detect the earliest signs of cancer. However, the literature reveals that, despite the availability of some level of infrastructural facilities for screening in low-and middle-income countries, very few women are screened in these countries due to their low acceptance of and participation in screening. Therefore, increasing the partic-ipation of women in cancer screening programmes is one of the major challenges for policy-makers. With this background, we attempted in this study to evaluate the effectiveness of financial incentives as an intervention to encourage women to accept and participate in a cervical cancer screening programme. Methods: Within a framework of randomized controlled trial (RCT) analysis, an experiment was conducted to evaluate the effectiveness of a financial intervention. The experiment was conducted in two districts of Assam, India. In total, 412 women participated in the experiment. Participants were divided between control and treatment groups on a random basis. Logistic regression was used to quantify the effectiveness of the financial intervention. Result: The likelihood of participation in a cancer screening programme was 20.5 times greater for those re-spondents who received financial assistance to attend the cancer screening programme. Conclusion: Financial incentive was found to be an effective intervention to encourage women to participate in a cervical cancer screening programme. The study also generated evidence that, along with financial incentives, there are other factors or determinants that also play a crucial role in a woman's decision-making process. Therefore, these factors should also be considered while formulating any policies for managing and controlling cervical cancer incidence. Policy summary statement: By introducing a financial incentive as an intervention, the problem of low acceptance and participation of women in cervical cancer screening programmes can be overcome to a significant level.