3. Screening ages and frequencies
In the context of an organised screening programme, for:
- asymptomatic women
- aged 50 to 69
- with an average risk of breast cancer
the ECIBC's Guidelines Development Group (GDG):
- recommends mammography screening (strong recommendation, moderate certainty of the evidence)
- recommends against annual mammography screening (strong recommendation, very low certainty of the evidence)
- suggests biennial mammography screening (conditional recommendation, very low certainty of the evidence)
Women aged 50-69: screening vs. no screening
Issued on: June 2016
Healthcare question
Should organised mammography screening vs. no 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) recommends mammography screening over no mammography screening, in the context of an organised population-based screening programme.
Recommendation strength
| Strong recommendation |
| Moderate certainty of the evidence |
Justification
The strong recommendation (rather than conditional) in favour of mammography screening over no mammography screening, in the context of an organised screening programme, was a result of a balance of the health effects that favours the intervention, in the context of moderate certainty in the evidence about these effects, and the cost-effectiveness of screening probably favouring the intervention.
Subgroup considerations
This recommendation does not apply to high-risk women (see recommendations for women with high breast density).
Considerations for implementation and policy making
Despite being a strong recommendation, women should be provided with the information regarding benefits and harms of screening.
Monitoring and evaluation
Future monitoring and evaluation of screening services should consider risks and benefits in the context of evolving treatment and management protocols. Monitoring and evaluation criteria have been developed within the ECIBC initiative.
Research priorities
- Further research on age-specific effects related to benefits and harms is needed.
- Better information/evidence about overdiagnosis is needed.
- A better understanding of the natural history of breast cancer.
- Stratification possibilities.
- Use of monitoring data to assess effectiveness (see monitoring).
- Role of breast density in stratification.
Supporting material