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Home » Breast Cancer, EU Health, Health, Healthcare Policy

ECIBC’s new screening recommendations to reduce the breast cancer burden in Europe

Submitted by on 14 Jul 2017 – 09:15

Aiming to reduce the burden of breast cancer and improve diagnosis and care of breast cancer in Europe, the European Commission Intiative on Breast Cancer (ECIBC) recently launched its first four recommendations for breast cancer screening. Donata Lerda, ECIBC Group Leader, spells out the scope of the European initiative and reveals future plans for the evidence-based guidelines for screening and diagnosis

The European Commission Initiative on Breast Cancer (ECIBC) is the European response to societal challenges and concerns of the citizens. It aims to empower women, patients and their families by offering transparent information on how and where to find evidence-based quality healthcare. The aim of ECIBC is to ensure and harmonise quality of breast cancer services across European countries.

The launch of the ECIBC originates from a strong common will of member states and EU institutions to reduce the burden of breast cancer. This sustainable initiative promoting effective treatment and care of breast cancer, collaborates with nearly thirty five European countries including 28 EU member states, plus Iceland, the former Yugoslav Republic of Macedonia, Montenegro, Norway, Serbia, Switzerland and Turkey. The goals of the ECIBC are also  endorsed and promoted by the European Parliament, patient organisations and stakeholders, who partake in the initiative.

Supported by nearly 70 European experts, including doctors and nurses coming from different specialities, patients and patients’ advocates, quality managers and methodologists, the ECIBC is a person-centered initiative, managed by the European Commission’s Joint Research Centre (JRC), under the auspices of the Directorate General for Health and Food Safety (DG SANTE). The JRC is independent of all national, private and commercial interests and the ECIBC transparently communicates the involvement of all parties, processes and decisions along its entire evolution.

The ECIBC was also born from the need to counteract the currently fragmented approaches to healthcare quality in breast cancer treatment in Europe. According to recent surveys conducted by the JRC, several existing quality assurance schemes are applied across Europe and are not always adaptable to local contexts. Furthermore, the past European breast cancer guidelines (2006) did not foresee monitoring and impact assessment.

Evidence-based guidelines for screening and diagnosis

In response to the Council of the European Union’s conclusions on reducing the burden of cancer, the ECIBC initiated a ground-breaking project to develop a European quality assurance scheme for breast cancer services underpinned by accreditation and referring to high quality, evidence-based guidelines.

The ECIBC published its first four recommendations on screening in November 2016. Tailored to the needs of citizens and patients, health professionals, and policy makers, they provide guidance on the appropriate age ranges (between 40 and 74) for breast cancer screening. This impacts a situation that has remained static for the last ten years.

Four guidelines available currently:

For women between 40 and 44

The ECIBC guidelines suggests not providing mammography screening to women between 40 and 44 years old who are at average risk of breast cancer and do not have symptoms.

For women between 45 and 49

For asymptomatic women aged 45 to 49 with an average risk of breast cancer, the ECIBC’s Guideline Development Group (GDG) suggests mammography screening over no mammography screening, in the context of an organised screening programme (conditional recommendation, moderate certainty in the evidence).

For women between 50 and 69

For asymptomatic women aged 50 to 69 with an average risk of breast cancer, the ECIBC’s Guideline Development Group (GDG) recommends mammography screening over no mammography screening, in the context of an organised screening programme (strong recommendation, moderate certainty in the evidence).

For women between 70 and 74

For asymptomatic women aged 70 to 74 with an average risk of breast cancer, the ECIBC’s Guideline Development Group (GDG) suggests mammography screening over no mammography screening, in the context of an organised screening programme (conditional recommendation, high certainty in the evidence).

These recommendations will be updated in real-time as evidence becomes available.Over the next two years, many more recommendations on screening and diagnosis will follow.

A platform of guidelines covering the whole care pathway

In 2017, ECIBC will release a guidelines platform, including evidence-based recommendations reviewed and assessed using the Appraisal of Guidelines for Research & Evaluation (AGREE II) Instrument in collaboration with one of the international centres of the Cochrane Collaboration, the Iberoamerican Cochrane Centre.

The European Breast Guidelines Platform will provide the evidence-base to develop the requirements and indicators of the European Quality Assurance scheme for Breast Cancer Services (European QA scheme). The European QA scheme will be adaptable to the varying national contexts, enabling comparison of services and continuous measurements and improvements when local implementation adheres to the evidence-based care standards.

Its implementation will guarantee that compliant breast cancer services will offer users (women, patients and carers) high quality and the most updated procedures for breast cancer screening and care.

The European QA scheme will address the needs of the breast cancer services, the quality dimensions and its implementation will be in compliance with the European legislation for accreditation. Before its piloting, the JRC will contact all countries to have a dialogue on possible barriers and incentives to implementing the QA scheme and the guidelines.

Towards the end of the pilot mission in 2018, the European QA scheme will be made available globally to all interested breast cancer services, such as hospitals, clinics and diagnostic centres.

Finally, a training template for digital breast screening will be developed. It will contain minimum training requirements for radiologists and radiographers providing digital breast screening in services adhering to the European QA scheme.

For more information and details on the methodology and outcomes, visit: ecibc.jrc.ec.europa.eu