The effect of deadlines on cancer screening completion: a randomized controlled trial

Alicea Lieberman,Stacie Miller,Emily Berry,Keith E Argenbright,Samir Gupta,Ayelet Gneezy,Mark Koch

doi:10.1038/s41598-021-93334-1

Abstract

Cancer is the second leading cause of death in the United States. Although screening facilitates prevention and early detection and is one of the most effective approaches to reducing cancer mortality, participation is low—particularly among underserved populations. In a large, preregistered field experiment (n = 7711), we tested whether deadlines—both with and without monetary incentives tied to them—increase colorectal cancer (CRC) screening. We found that all screening invitations with an imposed deadline increased completion, ranging from 2.5% to 7.3% relative to control (ps < .004). Most importantly, individuals who received a short deadline with no incentive were as likely to complete screening (9.7%) as those whose invitation included a deadline coupled with either a small (9.1%) or large declining financial incentive (12.0%; ps = .57 and .04, respectively). These results suggest that merely imposing deadlines—especially short ones—can significantly increase CRC screening completion, and may also have implications for other forms of cancer screening.

Highlights

Cancer is the second leading cause of death in the United States
The results of our field experiment demonstrate that specifying a deadline in fecal immunochemical tests (FITs) invitations increases completion
As anticipated, we found that shorter deadlines more effectively increased FIT completion than longer deadlines—particular in the short-term

Summary

Introduction

Cancer is the second leading cause of death in the United States. screening facilitates prevention and early detection and is one of the most effective approaches to reducing cancer mortality, participation is low— among underserved populations. Individuals who received a short deadline with no incentive were as likely to complete screening (9.7%) as those whose invitation included a deadline coupled with either a small (9.1%) or large declining financial incentive (12.0%; ps = .57 and .04, respectively) These results suggest that merely imposing deadlines—especially short ones—can significantly increase CRC screening completion, and may have implications for other forms of cancer screening. While researchers have identified a variety of factors that promote procrastination, a common theme is the perceived disconnect between one’s present and future selves, with pronounced focus on the former[16,18,21,22] This disconnect often leads people to prefer options that satisfy their present (vs future) self, a preference that is further accentuated with tasks involving immediate costs and/or delayed r ewards[15,19,23]. Being a strategy that aims to detect, as well as prevent

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Conclusion