Breast Cancer Screening

Since 2011, the Task Force has recommended against screening women aged 40 – 49.

The Task Force did not monitor the outcomes of its 2011 guideline, and unfortunately repeated the recommendation not to screen younger women in 2018. Since the 2011 Canadian Task Force recommendation not to screen women this age, there’s been an increase in the number of advanced cancers in women in their 40s and 50s. These women need more extensive surgery, more harsh chemotherapy, and are more likely to die of their cancers. In that same period, cancer has increased in younger women.

In May 2023, the United States Preventive Services Task Force draft guideline recommended screening women starting at age 40. Breast cancer experts in Canada, the US and in Europe have recommended this since the 1990s.

The Task Force has not acknowledged that Indigenous, Black, Asian/Filipina, and Hispanic women have a peak incidence of breast cancer in the 40s, whereas white women have a peak incidence in the late 50s, early 60s. Black women are 40% more likely to die of breast cancer than white women. In 2021, …more than one-quarter [of Canadian women] (26.8%) were part of a racialized group, while 23.8% were immigrants and 5.1% were Indigenous.” — Statistics Canada publication:  “The rich diversity of women in Canada”

The Canadian Cancer Society removed their endorsement of the Task Force breast cancer screening guideline in late 2022. On March 27th 2024, the Nurse Practitioner Association of Canada withdrew their endorsement as well.

Task Force guidelines overly utilize data that is more than 30 years old. The guidelines ignore new research that incorporates the use of newer technologies and which show a 40 to 60 per cent reduction in breast cancer mortality.” — position statement from the Canadian Society of Breast Imaging

 The Task Force recommendation against using tomosynthesis on average risk women, cited in the guidelines as a ‘strong recommendation, no evidence’ ignores the very large body of evidence on tomosynthesis which has been summarized in 2015 by the Canadian Agency for Drugs and Technologies in Health (CADTH).” — position statement from the Canadian Association of Radiologists