canadian task force updating breast screening guidelines, amid push for screening at age 40
currently, the task force recommends routine screening begin at age 50, although some provinces begin it earlier
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dr. jean seely, a researcher and radiologist at the ottawa hospital, says changes to the age that routine mammograms begin cannot come quickly enough in canada.
julie oliver
/
postmedia
a month after a u.s. task force recommended breast cancer screening begin at age 40, its canadian counterpart is also updating its recommendations. groups and individuals who have been pushing for changes to screening guidelines are applauding this week’s announcement from the federal government that it is investing up to $500,000 to allow the canadian task force on preventative health care to expedite its review of breast cancer screening guidelines.
canadian breast cancer patients, doctors, organizations and researchers have been pressing the task force to recommend breast cancer screening beginning at age 40 amid growing evidence about the number of early-stage cancers being missed, and the growing rates of breast cancer among women in their 40s.
currently, the task force recommends routine screening begin at age 50, although some provinces begin it earlier. in ontario, people can ask for screening in their 40s, but that seldom happens because the guidelines recommend routine screening begin at 50. the task force currently recommends shared decision making for women in their 40s about whether they should have a mammogram, but that recommendation has often been misunderstood. the task force launched its update of guidelines earlier this year, the federal funding is aimed at expediting that.
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dr. jean seely, the head of breast imaging at the ottawa hospital, president of the canadian association of radiologists and a leading researcher, is among those feeling hopeful about the news that the task force is updating its guidelines.
and seely said changes to the age that routine mammograms begin cannot come quickly enough in canada.
“this is really good news, but i find myself facing a lot of grief. i know so many people who are paying a penalty for these guidelines.”
seely said she saw a patient in ottawa this week who presented with stage 4 breast cancer at age 47.
“this happens over and over.”
not only does she see evidence in her practice, she is among researchers whose work has found that there are a higher proportion of later-stage cancers in canadian provinces that don’t begin routine breast cancer screening until age 50.
“just simply living in a province (where screening does not begin until 50) is associated with a later-stage diagnosis of breast cancer.” the later breast cancer is diagnosed, the higher the risk of poor outcomes, including death. the cost to the health system is also significantly higher.
seely’s research, in collaboration with statistics canada, also found that the incidence of breast cancer in women in their 40s has increased over the past 20 years, even more quickly in the past five years, a trend that is not well understood. that was a large part of the basis for the u.s. task force’s change in recommendations.
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andrea seale, ceo of the canadian cancer society, issued a statement saying the organization is pleased to hear of the investment by the government to expedite the task force review of breast cancer screening guidelines.
“the guidelines are a foundation of breast screening programs nationwide and since the guidelines were last updated, our understanding of breast cancer has continued to shift and expand. there is an obligation to ensure the guidelines are keeping pace so that we can feel confident that we are doing everything possible to improve breast cancer outcomes and help people live long, healthy lives.”
seely, meanwhile, said she remains a bit skeptical because there is no obligation for the task force to heed the advice of experts even though there is evidence that change is needed urgently.
“we are saying women are paying the penalty. it is affecting our society and we are losing women in the prime of their lives.”
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