Outdated breast cancer guidelines are putting people at risk, says Breast Cancer Canada head

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At a time when rates of breast cancer among young women rise, Canada’s outdated screening guidelines are putting women at risk, says the head of Breast Cancer Canada.

Kimberly Carson, the organization’s CEO, met with MPs this week to push for an update to breast cancer screening guidelines that support screening for women in their 40s across the country.

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Hers is among voices calling for changes to screening guidelines at a time when research has put a spotlight on rising rates of breast cancer among younger Canadians.

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A study led by Dr. Jean Seely, who heads the breast imaging section at The Ottawa Hospital, found a 45.5 per cent increase in breast cancer cases among women in their 20s since the 1980s.

For women in their 30s, that increase was 12.5 per cent and for women in their 40s, it was nine per cent during the same period. The study was published in the Canadian Association of Radiologists Journal late last month.

Those increases are concerning and merit greater attention, according to the study’s authors. Although rates have increased significantly, overall numbers of women in their 20s and 30s with breast cancer do not justify broad screening, but higher rates of breast cancer among women in their 40s do.

“A greater awareness amongst individuals and clinicians alike regarding the increasing number of cases of breast cancer in women younger than 50 is critical to allow for earlier diagnosis with its resultant reduced mortality and morbidity,” the authors wrote.

Those trends are among the reasons there has been a growing push for earlier breast cancer screening in Canada.

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Currently, the Canadian Task Force on Preventive Health Care recommends general screening for breast cancer begin at age 50. Those guidelines are due to be updated this spring.

Ontario is among the provinces that have lowered the age of broad breast screening below the age of 50, despite the guidelines, as have other provinces. But Carson said there remains a patchwork of recommendations across the country, including some that require a doctor’s referral. Those present barriers to widespread screening of women in their forties.

Breast Cancer Canada (BCC) wants to see federal guidelines allowing women across the country to refer themselves for breast cancer screening as of age 40, something researchers have shown would catch cancers at earlier stages.

Carson said BCC also wants to see a significant change in the timeliness of those guidelines. They are currently updated every 10 years. At a time when technology is rapidly changing around breast cancer detection and treatment, that time lag is leaving Canada behind, she said. BCC wants to see guidelines updated every two years.

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“We are losing women, and the treatment by the time they are diagnosed is very intense. If we catch it sooner, the treatment is usually fairly quick and not as invasive.” Carson said failing to catch breast cancer early puts undue stress, and risk, on patients as well as on the health-care system.

Carson said technology around treatment and detection of breast cancer is improving rapidly which can promote earlier detection. That includes a blood test being developed that could work as an early warning signal.

She said Canada is out of step with other countries, including the United States, in taking a “wait and see” approach to detecting breast cancer.

She also said more research is needed to better understand why women are getting breast cancer younger.

Researchers said increasing breast cancer rates among younger women “may reflect an interplay of lifestyle, reproductive, environmental and genetic factors. The American Cancer Society has attributed increasing breast cancer rates in women to risk factors that include older age of pregnancy, excess body weight, physical inactivity and alcohol consumption “all of which have been increasing in the USA,” said authors of the research.

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