2. Screening ages and frequencies
Women aged 40-44: 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 40 to 44?
Recommendation
For asymptomatic women aged 40 to 44 with an average risk of breast cancer, the ECIBC's Guidelines Development Group (GDG) suggests not implementing mammography screening.
Recommendation strength
| Conditional recommendation |
| Moderate certainty of the evidence |
Justification
The conditional recommendation (rather than strong) against mammography screening, in the context of an organised screening programme, was the result of a balance of the health effects that probably favours no mammography screening. GDG members agreed that mammography screening has large undesirable effects and small desirable effects when the first screening occurs at age 40.
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
GDG members agreed on the need for additional imaging techniques in this age group, as well as the need for shared decision making.
Monitoring and evaluation
Future monitoring and evaluation of screening services should consider benefits and risks in the context of evolving treatment and management protocols. Monitoring and evaluation criteria are being developed within the ECIBC initiative
Research priorities
- Carry out evaluations of the efficacy of the intervention, time intervals, risk factors and stratification of women, as well as context specific cost-effectiveness in this age group.
- Carry out studies addressing the role of other screening modalities (such as magnetic resonance imaging MRI) in this population.
Supporting material