Breast Cancer Screening Stakeholder Update

Breast Cancer Screening Stakeholder Update

The Canadian Task Force on Preventive Health Care would like to provide an update on its comprehensive evidence-based review of the 2018 breast cancer screening guideline as we develop the 2024 updated recommendations.

Task Force mandate and expertise

The Task Force is an independent group of primary care and prevention experts internationally respected and recognized for their expertise in evaluating evidence and developing preventive health care guidelines for primary care and for all Canadians.

It develops rigorous, evidence-based preventive health care guidelines based on the principles of impartiality, collaboration, and inclusivity. Members volunteer their time and expertise and are vetted to ensure neutrality in assessing evidence and developing recommendations; they do not have ties to industry or specialty organizations, nor financial conflicts of interest.

For each guideline, the Task Force relies on subject matter experts and patient partners. The breast cancer guideline update includes four content experts (a clinical oncologist, a radiation oncologist, a surgical oncologist, a radiologist), and two patient partners.

In addition, we work closely with research teams from across Canada — including the University of Alberta, University of Ottawa, University of Manitoba, Institute for Health Economics (Edmonton) and Unity Health (Toronto). Together, they are responsible for systematically reviewing and analyzing the scientific evidence for the guideline, and providing the Task Force with a state-of-the-art evidence summary on which to base recommendations, and knowledge translation.

What is the current guidance?

We know that discussions about breast cancer are of utmost concern to Canadians. It is important that accurate information be shared and understood.

Both the existing guideline and the updated recommendations currently in development are for women* with no personal or extensive family history of breast cancer, genetic risks or signs and symptoms of breast cancer — for example, a breast lump.

The current guideline emphasizes the importance of discussing the potential benefits and harms of screening between patients and health care providers; this conversation leaves the door open for anyone to explore breast cancer screening options.

After understanding the benefits and harms of screening, if a woman is interested in getting screened, they should have access to a mammogram. To reiterate – all women aged 40 years and older should be informed of the pros and cons of screening and if someone chooses to be screened, they should have access to mammography.

We are currently undergoing a detailed evidence review to update this guideline based on the latest evidence.

Comprehensive evidence and research review

The comprehensive review that engages both Task Force and external expertise assesses the available evidence, both past and current, including observational trials and modelling as well as randomized controlled trials — to ensure that updated recommendations are based on the best evidence available.

  • To date, the Task Force has invited over 120 individuals from 87 organizations and 22 individual experts to provide critical input on key documents (research plan, systematic review, draft guideline) for the breast cancer screening guideline.
  • 24 reviewers from 17 organizations, and 2 individuals provided input on the research plan; responses to all comments will be published.
  • In August 2023, the Task Force hosted an online portal through which people provided 145 documents from 19 individuals and 9 organizations that the Evidence Synthesis teams reviewed for potential inclusion.
  • The Task Force uses the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system, which is internationally recognized, developed and constantly refined by experts in evidence-based medicine, and used by guideline panels around the world.

Next Steps

The Task Force will publicly release its draft recommendations this year, and we will invite stakeholders and the public to provide feedback before they are finalized. We will advise of this timing once confirmed.

The Task Force is steadfast in its commitment to developing evidence-based guidelines to inform the health and well-being of Canadians by bringing the systematic analysis of evidence to the forefront of all discussions and decisions.

*Cisgendered women, adults assigned female at birth, transgender men and nonbinary people