Canada’s guidelines for routine breast cancer screenings will remain unchanged, despite mounting pressure from medical experts who have labelled them as “dangerous.”
The Canadian Task Force on Preventive Health Care released its updated guidelines Thursday recommending that people in their 40s should not get routine mammograms but can request one if they want.
The current guidelines set by the task force are to begin routine breast cancer screening at age 50.
“The first and most important recommendation coming out of this guideline is that breast cancer [screening] is a personal choice, and that people deserve information so that they can make the right choice for them,” said Dr. Kate Miller, a family physician and member of the Canadian Task Force on Preventive Health Care.
“We recommend that women between the ages of 40 and 74 are provided with information about the benefits and harms of screening to make a decision that aligns with their values and preferences,” she said during a media briefing on Thursday.
She added that this information should cover factors like family history, race or ethnicity, and breast density. If someone is aware of these factors and wishes to be screened, they should be offered mammography every two to three years.
The task force said it holds firm on its position not to lower the recommended due to concerns of over-diagnosis and unnecessary biopsies.
The new breast screening guidelines released today by the Canadian Task Force on Preventive Health Care are “dangerous and harmful to Canadians,” Dense Breasts Canada executive director Jennie Dale, said Thursday in an email to Global News.
“We are beyond disappointed in the recommendations,” Dale said. “The guidelines should reflect the latest evidence and prioritize the lives of Canadians. The Task Force has failed us and we ask Canadians to tell Minister Holland to suspend these guidelines and use modern science to save lives.”
Dr. Paula Gordon, a Vancouver-based radiologist, said in the same statement that she is “deeply concerned that Canadians will continue to face unnecessary later-stage breast cancer because of these guidelines.”
“There is good evidence that when breast cancers are detected earlier through screening, there is less need for harsh, debilitating treatments such as mastectomy, axillary dissection and chemotherapy,” she added.
Current guidelines ‘outdated and flawed’
The news comes more than a month after the Canadian task force was urged by many medical professionals to lower the current guidelines for breast cancer screening from 50 to 40, calling them “outdated.”
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Speaking at a media conference on April 15, Dr. Martin Yaffe, the co-director of the Imaging Research Program at the Ontario Institute for Cancer Research, said the task force’s age recommendation for breast cancer screening is “outdated and flawed.”
“The problem is that the women and their doctors are receiving dangerous guidance on breast cancer screening from the Canadian Task Force Preventive Health Care,” he warned.
“Besides the unnecessary deaths, many women also undergo harsh therapies for advanced cancer when their diagnosis is delayed. Much of this death and suffering could have been avoided if Canadian screening guidelines had been based on modern scientific evidence.”
The Canadian Cancer Society said Thursday in a release that it is “disappointed by the new breast screening guidelines” and “specifically the lack of a recommendation to lower the start age to systematically screen for breast cancer nationwide.”
On May 9, the Canadian Cancer Society released a statement urging all provinces and territories to begin breast cancer screening at age 40 for those at average risk of the disease.
The Canadian Task Force on Preventive Health Care is an independent, federally-appointed body that sets national guidelines used by family doctors to determine what kind of health screening patients require. According to its website, it comprises 15 primary care and prevention experts across Canada, such as family physicians, mental health experts and pediatricians.
Despite the recommendations, it is ultimately the provinces and territories that say when screening should begin, though, and many have already lowered the beginning age to 40.
Ontario announced in October 2023 that it would be lowering the starting age for screenings to 40, while B.C., Nova Scotia, P.E.I., and the Yukon have had the starting age at 40 for decades. New Brunswick recently changed its beginning age to 40 for screenings. A U.S. task force also recently changed its recommendations to age 40.
Sherry Wilcox, a 46-year-old lawyer from Toronto, expressed disappointment over the task force’s decision not to lower the screening age to 40. As a breast cancer survivor and advocate, Wilcox understands firsthand how challenging it is to request a screening when it is not recommended.
Despite her insistence at age 40, her doctor advised against it.
“I was told by my then family physician that because I had no family history and because I hadn’t yet reached the age of 50 it just didn’t make any sense,” she told Global News. “I didn’t know anything at the time. And of course, looking back, I wish I did know.”
Fast-forward four years later, she said she felt a lump on her breast. After pushing for another mammogram and then a biopsy, the results came in, she had an aggressive form of breast cancer.
Wilcox underwent a double mastectomy, radiation and chemotherapy. She is now cancer-free but remains concerned that her aggressive cancer could return at any time.
Because of her experience, Wilcox wants Canadians to be aware of their right to request a mammogram. She firmly believes that had she received one at 40, her cancer might have been less aggressive or she may have needed less treatment.
She believes that placing the burden on patients to request a breast screening from their doctor is harmful.
“Doctors are busy. And when the [task force] says it’s not recommended for women aged 40 to 49, that’ll be what [doctors] rest their eyes on,” she said. “There are a lot of women out there who will have trouble convincing their physicians that screening is for them and people trust their physicians. Physicians are in a position of power.”
Wilcox said the task force’s decision will result in more women being denied early screening, leading to later detection of more advanced cancers and subjecting them to more chemotherapy, radiation, and aggressive surgeries.
“These mammograms can catch cancers years before they can be felt. This is not news. It’s not controversial,” Wilcox said.
— With files from Global News’ Eric Strober