Skip to main content
European Commission logo
Cancer Screening, Diagnosis and Care

European guidelines on breast cancer screening and diagnosis


Select a topic

Screening









Select a topxic

Diagnosis








Select presentation view


Select a profile


3. Screening ages and frequencies

Women aged 50-69: triennial vs. biennial screening

Issued on: February 2017

Healthcare question

Should triennial mammography screening vs. biennial mammography screening be used for early detection of breast cancer in women aged 50 to 69?

Recommendation

For asymptomatic women aged 50 to 69 with an average risk of breast cancer, the ECIBC's Guidelines Development Group (GDG) suggests biennial mammography screening over triennial mammography screening, in the context of an organised population-based screening programme

Recommendation strength

Conditional recommendation
Very low certainty of the evidence

Justification

The GDG felt that the health effects probably favour biennial screening over triennial screening. There were moderate savings in doing triennial screening, however, neither was favoured with regards to cost effectiveness, but triennial screening was considered to be feasible.

Considerations for implementation and policy making

The GDG felt that selection of the screening interval should be dependent on the resources available and sustainability of the costs of a specific country.

In contexts where screening programmes do not already exist, the GDG felt that it would be better to have a triennial screening interval than no screening programme at all.

In contexts where triennial screening interval is currently used, the GDG recognised that human resource (radiologists/radiographers) availability may determine the decision.

Research priorities

  • The GDG agreed that more research on the effectiveness of the different screening intervals, comparative studies, would be helpful due to the very low certainty of the evidence.
  • The GDG felt that the implications of breast density on appropriate screening intervals should be prioritised as this could be a risk modifier that may need different intervals.
  • The GDG discussed the need for improved knowledge on radiation dose and the differences that screening intervals would have on the radiation dose received by women.
  • The GDG felt that increased cost effectiveness data, having more contextualised costs and cost-effectiveness analysis and from other settings would be helpful for future recommendations; this included checking the consistency of cost-effectiveness models with new research from trials on breast cancer screening and natural history of breast cancer disease. Also many countries have cost analysis but are not publicly available, and this should be shared with the scientific community.

Supporting material

yes