[Balancing risks and benefits of mammography screening for breast cancer: would you support its recommendation in Peruvian women?]

Abstract

The aim of this study is to assess the balance between benefits and risks of population-based mammography screening programs in Peruvian women. We followed the criteria proposed by the GRADE (Grading of Recommendations Assessment, Development and Evaluation) working group. A generic search strategy for published studies was performed using Medline and other sources of national data (gray literature). The evidence of benefits, risks, costs and preferences of the population was used in order to state a recommendation in favour, or against, screening. We found five systematic reviews (SR) that evaluated the balance between benefit and risks, two economic evaluations based on Peruvian data, and one study that reported the preferences of Peruvian women. The quality of evidence of the SR was moderate in favour of screening in women aged 50-69 years. The balance of risks and benefits showed a higher probability of overdiagnosis compared with the reduction in mortality. The most cost-effective strategy was the triennial mammography. Perceived barriers could seriously compromise the participation of women. In conclusion, the recommendation of mammography screening for Peruvian women is weak, even more if we take into account other health necessities of the population. However, if implemented, triennial mammography in women aged 50-69 years could be the more suitable screening strategy.