Authors' objectives:

This study aimed to assess whether the French breast cancer screening programme should be extended to women aged 40-49 with no history of breast cancer or hereditary risk, using WHO criteria. This is an update of the ANAES 1999 guidelines.

Authors' results and conclusions: Prevalence of the disease: 7,758 new cases (40-49 year olds) in France in 2000. History of the disease: Three prospective case series were identified in women aged 40-49 years. There were no conclusive differences in breast cancer (tumour progression, differentiation, lymph node involvement) in these women compared to older women. Test performance: One prospective and two retrospective case series using the only validated screening method (conventional mammography) were identified in 40-49 year olds. There were no conclusive differences in test performance in these women compared to older women. Benefits of mass screening by conventional mammography: Follow-up data were available for three randomised controlled trials in women aged 40-70 years, only one of which specifically studied a subpopulation of 40-49 year olds. A non-randomised comparative study and two historical cohort studies included a subpopulation of 40-49 year olds. There was no evidence that screening of younger women had any benefit in relation to mortality from breast cancer. Disadvantages of screening: Disadvantages are false positive or false negative mammography results, overdiagnosis and overtreatment. Studies of a low level of evidence have concluded that radiation-related risks are at least equivalent to those in women over 50.

Authors' recommendations: No extension of the French breast cancer screening programme to women aged 40-49 should be envisaged until efficacy and cost-effectiveness in older women (50-74 years) have been proven.

Authors' methods: Systematic review

Project Status: Completed

URL for project: http://www.has-sante.fr/

Year Published: 2004

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: France

Organisation Name: L'Agence Nationale d'Accreditation d'Evaluation en Santé

Contact Address: 2 avenue du Stade de France, 93218 Saint-Denis La Plaine Cedex, France. Tel: +33 01 55 93 71 88; Fax: +33 01 55 93 74 35;

Contact Name: sh.leerobin@has-sante.fr

Contact Email: sh.leerobin@has-sante.fr

Copyright: L'Agence Nationale d'Accreditation d'Evaluation en Sante (ANAES)