OTTAWA, ON -
The Canadian Cancer Society is disappointed by the new breast screening guidelines released today by the Canadian Task Force on Preventive Health Care (CTFPHC) and specifically the lack of a recommendation to lower the start age to systematically screen for breast cancer nationwide.
Earlier this month, CCS released its new position on breast screening calling for provinces and territories, that had not already done so, to reduce the start age of screening programs to 40 for women and trans, non-binary and gender diverse people at average risk of breast cancer. CCS updated its position to reflect evolving evidence and a groundswell of support from patients for a more inclusive system with access for younger ages.
In the guidelines released today, the CTFPHC suggested not to systematically screen with mammography for ages 40-49. However, the guidelines also recognize the importance of personal choice and acknowledge that individual values and preferences may differ so those who wish to be screened should be offered mammography every 2-3 years. While this is a meaningful improvement over the 2018 guidelines, it places the onus on people to advocate for their own early detection and screening and gain access to a referral rather than being automatically invited to provincial and territorial programs.
“We respect the CTFPHC, their collective expertise and their consideration of evidence, but we have an obligation to listen to patients who have been loud and clear that they do not feel represented by the guidelines. They have shared frustrations at having to fight for inclusion in screening, the reliance on healthcare providers for access to screening, and the lack of clarity around when they should be screened. Today’s guidelines disregard those voices and continue to place the burden of navigating the system on the shoulders of people who needed more support and guidance,” says Dr Sandra Krueckl, Executive Vice President, Mission, Information and Support Services.
Breast cancer is the most commonly diagnosed cancer and the second leading cause of cancer-related death among women in Canada. The breast cancer death rate has decreased by over 40% since the early 1990s, which is largely attributed to a combination of increased mammography screening and the use of more effective treatments after diagnosis. Access to breast screening is important to find breast cancers early when chances of successful treatment are better.
The breast screening guidelines were last updated in 2018. The guidelines are a foundation of breast screening programs nationwide and one of the considerations as provinces and territories design their respective programs and set screening start and stop ages. There are a growing number of provinces across Canada who already provide access to breast screening services starting at age 40.
The CTFPHC also considered guidelines for people at elevated risk of breast cancer including those with family history and dense breasts, and found no evidence on the benefits of supplemental screening, such as MRI or ultrasound. CCS believes all women with elevated or high risk should have the option of additional screening and speak with their healthcare provider about their personal risk factors to make an informed decision. CCS also recommends governments collect data to build more evidence on supplemental screening, support pilots of supplemental screening and monitor outcomes, and support healthcare providers in discussing the benefits and limitations of supplemental screening.
“Research and data play a critical role in the work of the CTFPHC. For this reason, governments and funders need to continue investing in research and collecting data – including race-based data – so that we can all better understand breast cancer risk, screening and barriers to screening,” adds Dr Krueckl.
In releasing the new guidelines, the CTFPHC has opened a public consultation period for the first time on their draft guidelines where people are invited to provide feedback before they are finalized. CCS will be participating in the public consultation and calls on the CTFPHC to share how the public input will further shape the final guidelines. CCS strongly encourages people to share their views, opinions and feedback through this consultation process. It’s an essential step in ensuring the guidelines reflect the voices and perspectives of people eligible for breast screening and impacted by breast cancer in Canada. The consultation will be open for the next 6 weeks. To participate, visit canadiantaskforce.ca after 1pm ET on May 30.
CCS also encourages people to know what’s normal for your breasts. A change to your body might be nothing, but it might be serious. Always see a healthcare provider if there are any changes to how you’re feeling or if you have new physical symptoms. Get changes checked sooner rather than later. To learn more about breast cancer, visit cancer.ca/breast or call 1-888-939-3333.
Summarizing action needed
CCS continues to strongly recommends comprehensive action in the following areas to ensure equitable and timely access to breast screening:
- Investing in research
- Enhancing data collection
- Developing guidelines for people who have elevated and higher risk
- Updating screening eligibility for average risk including lowered age
- Enhancing breast cancer screening programs to address distinct population needs
- Building awareness about existing breast screening programs
- Co-developing solutions to increase participation in communities that are underserved
- Investing in health human resources
About the Canadian Cancer Society
The Canadian Cancer Society works tirelessly to save and improve lives. We raise funds to fuel the brightest minds in cancer research. We provide a compassionate support system for all those affected by cancer, across Canada and for all types of cancer. Together with patients, supporters, donors and volunteers, we work to create a healthier future for everyone. Because to take on cancer, it takes all of us. It takes a society.
Help us make a difference. Call 1-888-939-3333 or visit cancer.ca today.
For more information, please contact:
Jessica Abdilla
Communications Manager, Canadian Cancer Society
(437)-266-8972
jessica.abdilla@cancer.ca