department of economics screening for cancer and market structure a multilevel analysis mammogram pap smear utilization in the us 1 by yavuz ya?ar university denver 2040 s race street co 80208 phone 303 871 2244 fax 2605 e mail yyasar du edu last revised february 2005 please do not quote without author permission jel classification i10 i18 l11 l21 l52 keywords health care this paper is based on ph d dissertation he would like to thank norman waitzman cihan bilginsoy ken r smith tom n maloney regula burki md utah their helpful comments encouragement responsible all remaining errors 0 abstract investigates relationship between preventive services namely papanicolaou addition life saving aspects it always believed that are important due cost effectiveness which prevail under managed competition yet nature has been changing as result backlash against