Neither breast cancer prevention and early-detection programs, nor their
outcomes, are uniform across Europe. This article describes the
rationale, methods, and process for development of the European
Commission ( EC) Initiative on Breast Cancer Screening and Diagnosis
Guidelines. To be consistent with standards set by the Institute of
Medicine and others, the EC followed 6 general principles. First, the EC
selected, via an open call, a panel with broad representation of areas
of expertise. Second, it ensured that all recommendations were supported
by systematic reviews. Third, the EC separately considered important
subgroups of women, included patient advocates in the guidelines
development group, and focused on good communication to inform women's
decisions. Fourth, EC rules on conflicts of interest were followed and
the GRADE ( Grading of Recommendations Assessment, Development and
Evaluation) Evidence to Decision frameworks were used to structure the
process and minimize the influence of competing interests. Fifth, it
focused its recommendations on outcomes that matter to women, and
certainty of the evidence is rated for each. Sixth, the EC elicited
stakeholder feedback to ensure that the recommendations remain up to
date and relevant to practice. This article describes the approach and
highlights ways of disseminating and adapting the recommendations both
within and outside Europe, using innovative information technology
tools