Should breast cancer screening age be lowered in Canada? Task force says no — but advocates are 'deeply concerned'

Despite many provinces across Canada changing their mammogram guidelines, the Canadian Task Force on Preventive Health Care says women of average risk shouldn't be "systematically" screened for breast cancer in their 40s.

On Thursday, the federally-created task forced released draft recommendations for breast cancer screening specifically for women of average or "moderately increased risk" of developing the disease. The guidelines state that women aged 40-49 who have been informed of the "benefits and harms" of screening and want to proceed should be offered a mammogram every 2-3 years.

In Canada, women over 40 can currently refer themselves for a mammogram in British Columbia, Prince Edward Island, Nova Scotia, Nunavut and Yukon. Ontario is expected to lower its self-referral age to 40 this fall, while Alberta allows women access to publicly funded mammograms at 45.

The task force considers screening at all ages a "personal choice" and says that anyone over 40 who wants a mammogram should have one — but believes that the "harms may outweigh the benefits" for women in their 40s. According to the CBC, the task force considers the harms to be "unnecessary tests and anxiety."

The guidelines do not apply to women with a family history or genetic mutation that make them more susceptible to breast cancer or women with symptoms of breast cancer.

Advocates 'deeply concerned by screening guidelines

Breast Cancer Canada said it was "deeply concerned" by the task force's guidelines and urged them to reconsider their stance. In an online press release, the group said the latest guidelines "contradict clear evidence and emerging trends that underscore the critical importance of early detection" and ignores the calls from Canadians to lower screening age. A September 2023 poll by Breast Cancer Canada found that 89 per cent of Canadians believe the breast cancer screening age should be lower than 50.

"The task force’s decision to not advise routine screenings for women in their 40s fails to acknowledge the advancements in screening and detection and what research is showing us including the increase in early-age breast cancer over the past 20 years,” Kimberly Carson, CEO of Breast Cancer Canada, said in a press release. “Early detection saves lives. The benefits of early detection and the opportunity to treat cancer before it advances, spreads, and becomes more complicated significantly outweigh the harms of mammograms as cited.”

Breast Cancer Canada says the guidelines lack "patient voice" and although there is a "margin of error" they remain an invaluable asset.

"Unfortunately my breast cancer was more developed and had spread to my lymph nodes when I was diagnosed at age 46” Parminder Punia of Toronto told Breast Cancer Canada. “Routine screenings beginning at age 40 would have meant my breast cancer might have been treated through removal of the tumour, not the entire breast. Patients could be spared the side-effects of chemotherapy and diagnosed before the cancer advances and invades other parts of the body.”

According to the Canadian Cancer Society, approximately 30,500 women will be diagnosed with breast cancer in 2024, an average of 84 per day. Breast cancer accounts for 13 per cent of all female cancer deaths in Canada, with 5,500 women expected to die from breast cancer this year.

Evidence shows breast cancer is on the rise for women under 50

In April, a new study published in the Canadian Association of Radiologists Journal indicated that rates of breast cancer in women are on the rise, especially for women in their 20s, 30s and 40s.

“We’re calling for increased awareness among healthcare professionals and the public regarding the rising incidence of breast cancer in younger women,” Dr. Jane Seely, the study's lead author, said in a news release. “We need to adapt our strategies and policies to reflect these changing trends, ensuring that all women, regardless of age, have access to the information and resources they need to detect and combat this disease."

Where each Canadian province stands on breast cancer screening

Alberta

Publicly funded routine breast cancer screening begins at age 45 in Alberta. Women aged 45 to 74, who live in Alberta and have no symptoms or family history, are eligible for regular mammograms every 2 years.

British Columbia

Regular mammograms are available to B.C. women at the age of 40, every two years. Though available, routine mammograms are still “not recommended” for ages 40-49, but starting at 50.

Manitoba

Manitoba encourages women aged 50-74 to have a screening mammogram every two years. Routine screening is not recommended for the 40-49 age group.

New Brunswick

Women living in New Brunswick can self-refer to a routine mammogram between the ages of 50 and 74. Mammograms are currently available to women aged 40 to 49 with a doctor referral. However, the eligibility age will be lowered to 40 in early 2024.

Newfoundland and Labrador

The breast screening program in N.L. offers routine screening mammography to women aged 50-74 years.

Nova Scotia

Asymptomatic women are recommended to get an annual mammogram in Nova Scotia at the ages of 40-49. Between the of 50 and 74, women are advised to get a mammogram every two years.

Ontario

Currently, Ontario’s breast cancer screening program allows routine mammograms for women aged 50 to 74. However, in fall of 2024, the eligibility age will drop to 40.

Prince Edward Island

A publicly funded mammogram is available to P.E.I. women annually, between the ages of 40 and 74.

Quebec

Women in Quebec are eligible for a mammogram to screen for breast cancer between the ages of 50 and 69, every two years.

Saskatchewan

Routine mammograms in Saskatchewan are available to residents aged 50 to 74, every two-to-three years.

Northwest Territories

The Northwest Territories public health recommends mammograms to women between the ages of 50 and 74, every two years.

Nunavut

There is no organized breast cancer screening program in Nunavut, but mammograms are available annually starting at the age of 40.

Yukon

Women in Yukon can access routine screening every year between the ages of 40 and 49. Between the ages of 50 and 74, it is recommended at least every two to three years.

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