Age Limits of Breast Cancer Screening with Mammography—A Decision-Analytic Benefit–Harm Evaluation to Inform DecisionMaking for the German Context
TL;DR
It is suggested that inviting women aged 45–74 for a mammogram every two years could prevent more breast cancer deaths and modestly extend both life expectancy and quality-adjusted life expectancy with an acceptable trade-off in additional testing, while more extensive screening brings less favorable incremental harm–benefit ratios.
Abstract
Simple Summary Breast cancer screening in Germany currently invites women aged 50–69 for a mammogram every two years. We used a Markov Model considering German data and practice patterns to compare several screening strategies that start at younger ages, end later, and varied how often mammograms are performed. We looked at patient-relevant outcomes such as breast cancer cases and deaths prevented, life expectancy, quality of life, and the number of extra mammograms and false-positives—to weigh benefits against burdens. Our results suggest that inviting women aged 45–74 for a mammogram every two years could prevent more breast cancer deaths and modestly extend both life expectancy and quality-adjusted life expectancy with an acceptable trade-off in additional testing, while more extensive screening brings less favorable incremental harm–benefit ratios. For policymakers, the results offer country-specific transparent evidence to refine screening guidelines.