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Cancer Screening, Diagnosis and Care

European guidelines on breast cancer screening and diagnosis


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3. Screening ages and frequencies

Women aged 70-74: 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 70 to 74?

Recommendation

For asymptomatic women aged 70 to 74 with an average risk of breast cancer, the ECIBC's Guidelines Development Group (GDG) suggests triennial mammography screening over biennial mammography screening, in the context of an organised population-based screening programme

Recommendation strength

Conditional recommendation
Very low certainty of the evidence

Justification

The reasons for a conditional recommendation are the sustainability of the screening programme, the cost of the intervention and the resources available.

Considerations for implementation and policy making

In countries where women have been screened biennially for twenty years, triennial screening may not be acceptable and would require designing implementation strategies.

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.
  • Due to the growing ageing population, the GDG believed women in the older age groups would need to have a longer follow-up in order to see how many breast cancers are detected at those ages. In addition, the GDG believed there was a need for more data on interval cancers in the varying screening intervals, as there is currently very little data on this.
  • 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 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

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