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Canada

‘This is great news’: doctors applaud move to modernize cancer screening guidelines

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Women in their 40s in Ontario can now book a mammogram without needing a doctor's referral. (Kimberly P. Mitchell/THE CANADIAN PRESS)

Advocates and doctors are applauding the recently released external expert panel report on the Canadian Task Force on Preventive Health Care, which calls for modernization and reform of the task force.

Some of the recommendations to modernize the task force include ensuring preventive health care guidelines remains up to date with evolving scientific data and are updated in a timely manner, the inclusion of equity-centred perspectives, patient involvement, and collaboration with pre-existing guidelines to help eliminate disparities across the country.

“This is great news,” said Dr. Anna Wilkinson, a family physician and general practitioner-oncologist at The Ottawa Hospital, in a phone interview with CTVNews.ca.

“They are saying that we need to modernize the task force, and I think that’s because we’re recognizing that we are kind of behind the times on our cancer screening guidelines and many of our other preventive health care guidelines.”

Task force halted amid criticism

The task force is an independent body responsible for developing national preventive health guidelines for family doctors on cancer screening and other disease prevention measures.

Their work was halted last year following criticism of its proposed incoming breast cancer screening guidelines, which did not recommend mammography screening begin at age 40.

Instead, it upheld its 2018 guidelines recommending screening begin at age 50, despite growing evidence and calls from numerous medical experts and organizations urging earlier screening in response to rising breast cancer rates among younger women.

This prompted then-Health Minister Mark Holland to request that the Public Health Agency launch an external expert review panel, which began in October 2024, to recommend changes and improvements to the task force’s structure, governance, and methodology for developing the guidelines.

Dr. Wilkinson, one of the medical experts who provided feedback to the external review panel, says she is pleased the report acknowledges the need to modernize the task force.

“We cannot afford economically as a health system to not be,” she said.

“We know that it’s so much cheaper to deal with cancers when they’re smaller, we know the outcomes are better, the cost to our health-care system is better.”

“I think one of the ways forward for a health-care system is to do preventive care more effectively. (…) This is a high-level view of how we might do that, so I look forward to seeing how it gets implemented.”

With implementation of the recommendations currently underway, Health Minister Marjorie Michel has requested that the Public Health Agency of Canada have the task force operational by April 2026.

‘Landmark change’

Kimberly Carson, CEO of Breast Cancer Canada, was one of many advocates calling for the incoming breast cancer guidelines to recommend screening begin at age 40 rather than 50.

Carson, who met with Holland and the external expert review panel, is content with the report’s findings.

“It’s going to be fantastic for Canadians,” Carson told CTVNews.ca in a phone interview.

“We know that if we catch breast cancer early, it’s better for the patient, it’s better for the health-care system, it costs less, there’s less financial toxicity for the patients and a better cure rate. (…) It changes the paradigm for Canadian patients.”

The task force began meeting on the upcoming breast cancer guidelines in May 2023.

For two years, Breast Cancer Canada advocated for the inclusion of subject matter experts in guideline development, the timely integration of the latest data, and the incorporation of patient perspectives.

With the report acknowledging all these points, Carson says she is satisfied that the sustained mobilization efforts have yielded results.

“It’s such a landmark change in a landmark decision,” Carson said.

The Canadian Cancer Society, which stated in a media release its approval of the report, also had its recommendations reflected in the findings.

Some of these recommendations echo those of Breast Cancer Canada, including the inclusion of cancer experts, patient perspectives, and staying current with evolving perspectives, experiences and scientific evidence.

“Once they reform the task force and it becomes functional in April, we would hope that they would immediately take a look at the screening guidelines for breast cancer,” Carson added.

In addition to the 2018 breast cancer guidelines, the current cancer screening guidelines for other cancers — like colorectal cancer (2016), prostate cancer (2014), and cervical cancer (2013) — are also due for updates, Dr. Wilkinson notes.

She says this report is a “critical step” towards modernizing all of Canada’s screening guidelines.

“In today’s strained health-care environment, optimizing preventive care is essential to making the most of our limited resources,” she said in an email to CTVNews.ca. “The integration of diverse and evolving evidence, equitable care and ongoing evaluation pave the way for agile, ‘living’ guidelines that keep pace with scientific advancements.

“This approach will help ensure Canada no longer relies on cancer screening recommendations that are over a decade old.”