Critics call new breast cancer screening guidelines out of date and ‘dangerous to Canadians’

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Organizations representing breast cancer patients, experts and others were quick to respond Thursday to long-awaited new guidelines from the Canadian Task Force on Preventative Health Care recommending against routine screening at age 40.

“This is just not in line with the current evidence and it is a big disappointment,” said Dr. Jean Seely, who is head of breast imaging at The Ottawa Hospital. “It is very bad news for Canadian women.”

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Seely was lead author of a study published earlier this year that found rates of breast cancer in younger women had been increasing.

She said the task force continued to rely on outdated research and its members didn’t have the knowledge base they should have. Seely is among experts now calling for the task force to be disbanded.

Although it didn’t recommend routine screening at age 40, which Seely and others say growing evidence supports, the task force did say that those wanting screening at 40 should be able to get it, “after understanding the benefits and the harms.”

Jenny Dale, executive director of Dense Breasts Canada, called the updated guidelines “dangerous and harmful to Canadians” and said they didn’t reflect the latest evidence. The organization is among those that have been calling for routine breast cancer screening to begin at age 40 in Canada, something recommended by a similar task force in the United States and by growing numbers of organizations, including the Canadian Cancer Society.

“I am deeply concerned that Canadians will continue to face unnecessary later-stage breast cancer because of these guidelines,” radiologist Dr. Paula Gordon said.

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The Canadian task force will continue to recommend that routine breast cancer screening begin at age 50 for those with normal risk factors, a position that has increasingly put it out of sync with many experts and with public opinion.

Federal Health Minister Mark Holland said Thursday he had “serious concerns” about the guidelines.

Gatineau physician Dr. Guylaine Theriault, who chairs the task force, said it could not find compelling evidence to make a recommendation to lower the screening age to 40 and it would result in significant over-testing.

“Screening might be beneficial, but it might also cause harms,” she said. “People may find that information about breast cancer screening is surprising — there are potential benefits to screening, but there are also harms. We want women to have all the information they need to make the decision that’s right for them.”

The recommendations represent a split with the Canadian Cancer Society, which recently urged all provinces and territories to begin screening women at age 40. It is something the majority of Canadian provinces now do, but experts say the task force guidelines will continue to create a barrier to people getting screened because of its latest recommendations.

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Dr. Ify McKerlie, principal radiologist at Calgary’s Women’s Imaging Centre, said the risk was “a particularly urgent concern” for Black women, who are 40 per cent more likely to die from breast cancer.

“I am troubled that these new guidelines do not ensure that my patients get the kind of care they need to live health, productive lives,” McKerlie said.

Member of the task force called for more research to inform screening guidelines for the Black population and women with dense breasts, which are more difficult to diagnose.

Dr. Sandra Kruekl of the Canadian Cancer Society said officials needed to pay attention to the call from many for earlier screening.

“Over the last several years, there has been a groundswell of support for screening to begin at a younger age and for a more inclusive system: one that empowers people between the ages of 40 and 49, no matter where they live, to access screening without barriers,” Kruekl said. “We need to heed that call, as well as ensure there is clear guidance for people who have an elevated or high risk of developing breast cancer, such as people with genetic mutations, family history or dense breasts.”

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