2025/05/26 Education as Prevention: Long-Term Health Impacts of Expanded Schooling for Girls on Women’s Cancer

A new study published in Nature Communications highlights the powerful role of girls’ education in improving women's health outcomes in Lesotho. Researchers from Harvard and the University of Cape Town used a natural experiment to demonstrate that increasing educational attainment among girls significantly boosts awareness and screening for breast and cervical cancer, two leading causes of death and disability among women in Sub-Saharan Africa.
 
The study, led by Janny Liao and colleagues, capitalized on a school-entry age cut-off policy in Lesotho that caused quasi-random variation in years of schooling among women. Drawing on data from nearly 8,000 women aged 25 to 49 in the Lesotho Demographic and Health Surveys of 2009–10 and 2014, the team found that each additional year of schooling caused by the policy increased awareness of breast cancer by 4.7 percentage points, knowledge of Pap smears by 5.9 points, and Pap smear uptake by 3.5 points.
 
“These findings offer causal evidence that investing in girls’ education has long-term health benefits beyond the classroom,” said co-author Dr. Jan-Walter De Neve. “Improved education translates into greater health awareness and action, which are crucial for early detection and prevention of cancer.”
 
Despite the high general awareness of breast cancer in Lesotho, the study revealed low screening rates: only about 8% of women had ever undergone a clinical breast exam, and 14% had received a Pap smear by 2014. Health insurance coverage remained rare, and infrastructure for cancer prevention and treatment is limited.
 
This research is one of the first to establish a causal link between education and cancer screening behavior in a low- and middle-income country. The authors emphasize that natural experiments, like this one, provide valuable policy insights that randomized trials often cannot offer.
 
As Lesotho and other countries seek strategies to reduce preventable deaths, this study reinforces that expanding access to education for girls can serve as a foundation for improving public health and health equity.
 
https://www.nature.com/articles/s41467-025-58875-3