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Society and expert recommendations for routine mammographic screening in women at average risk

Society and expert recommendations for routine mammographic screening in women at average risk
Group (date) Frequency of screening (years) Initiation of screening for women at average risk
40 to 49 years of age 50 to 69 years of age ≥70 years of age
Government-sponsored groups
US Preventive Services Task Force (2016)[1] 2 Individualize* Yes Yes, to age 74
Canadian Task Force on Preventive Health Care (2018)[2] 2 to 3 Recommend against* Yes Yes, to age 74
National Health Service, United Kingdom (2018)[3] 3 Yes, start age 47 Yes Yes, to age 73
Royal Australian College of General Practitioners (2018)[4] 2 No Yes Yes, to age 74
Medical societies
American College of Obstetricians and Gynecologists (2017)[5] 1 to 2* Individualize* Yes Yes, to at least age 75
American College of Physicians (2019)[6] 2 Individualize* Yes Yes, to age 74
American Cancer Society (2015)[7] 1 year age 45 to 54

Individualize* through age 44

Yes, start age 45		 Yes YesΔ
1 to 2 years age ≥55
American College of Radiology (2017)[8] 1 Yes Yes Yes◊
Coalitions
National Comprehensive Cancer Network (2018)[9] 1 Yes Yes Yes
* Women should be counseled about the harms and benefits of mammography; individualized decisions should include shared decision-making based on risks, benefits, patient values and preferences.
¶ Decision to discontinue screening mammography should be based on a shared decision-making process informed by the woman's health status and longevity.
Δ If in good health and life expectancy >10 years.
◊ Individualize to current health and life expectancy; if a woman is in reasonably good health and would be a candidate for treatment, then should continue screening.
References:
  1. US Preventive Services Task Force. Screening for Breast Cancer: US Preventive Services Task Force recommendation statement. Ann Intern Med 2016; 164:279.
  2. Canadian Task Force on Preventive Health Care, Klarenbach S, Sims-Jones N, Lewin G, et al. Recommendations on screening for breast cancer in women aged 40-74 years who are not at increased risk for breast cancer. CMAJ 2018; 190:E1441.
  3. National Health Service. When it's offered: Breast cancer screening. Available at: https://www.nhs.uk/conditions/breast-cancer-screening/when-its-offered/ (Accessed on June 18, 2019).
  4. The Royal Australian College of General Practitioners. Guidelines for preventive activities in general practice, 9th ed, East Melbourne, RACGP 2018.
  5. American College of Obstetricians-Gynecologists. Practice bulletin no. 179: Breast cancer risk assessment and screening in average-risk women. Obstet Gynecol 2017; 130:e1-16.
  6. Qaseem A, Lin JS, Mustafa RA, et al. Screening for breast cancer in average-risk women: A guidance statement from the American College of Physicians. Ann Intern Med 2019; 170:547.
  7. Oeffinger KC, Fontham ETH, Etzioni R, et al. Breast cancer screening for women at average risk: 2015 guideline update from the American Cancer Society. JAMA 2015; 314:1599.
  8. Mainiero MB, Lourenco A, Mahoney MC, et al. ACR Appropriateness Criteria Breast Cancer Screening. J Am Coll Radiol 2013; 10:11.
  9. National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in oncology: Breast cancer version 2. 2018.
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