Female preventive practices: breast and smear tests.

Breast cancer and cervical cancer are the most common female cancers in Spain and in many developed countries. The main goal of this paper is to identify the determinants of individual decisions on breast screening and smear testing, that is to say, the decision to take a test for the first time and the decision to test with suitable regularity. To that end, we have combined analyses of micro and macro data (the Spanish National Health Survey and Spanish Regional Social Indicators) and employed multilevel estimation models. Among the main results, we highlight the fact that regional public screening programmes improve individual decisions on screening (more women testing for the first time and more women testing regularly) and, furthermore, they generate positive synergies; for example, regional public programmes for smear testing improve individual decisions on both cervical and breast cancer screening. In addition, we conclude that it is not only important to know if the numbers of women undergoing breast screening and smear testing are increasing, it is also important to know if they are testing regularly.