Global guidelines for breast cancer screening: A systematic review

Area of Science:

• Oncology
• Public Health
• Evidence-Based Medicine

Background:

• Breast cancer screening guidelines are crucial for clinical decision-making.
• Information on the global landscape and variations in breast cancer screening guidelines is limited.

Purpose of the Study:

• To systematically review current international breast cancer screening guidelines.
• To summarize recommendations and assess guideline quality.
• To provide references for clinical practice and identify areas for improvement.

Main Methods:

• Systematic searches of major databases (MEDLINE, EMBASE, Web of Science, Scopus) up to March 2021.
• Quality assessment using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument.
• Extraction and summarization of guideline information and recommendations.

Main Results:

• 23 guidelines from 11 countries (2010-2021) were identified, showing variability in content and quality (AGREE II scores 33.3%-87.5%).
• Most guidelines recommend mammographic screening for average-risk women aged 40-74 (optimal 50-69), with annual or biennial intervals.
• High-risk women should undergo annual mammography or MRI starting earlier; common risk factors include personal/family history, genetic predisposition, radiation therapy, and dense breasts.

Conclusions:

• International breast cancer screening guidelines, primarily from developed nations, share similar but not identical recommendations on age, methods, and intervals.
• Mammography is the primary screening tool for average-risk women, while mammography or MRI is recommended for high-risk groups.
• Improvements in methodological quality are needed, and low- and middle-income countries should adapt high-quality guidelines considering local contexts.