Breast cancer screening recommendations: Canada and the United States
- What are the Canadian Task Force and US Task Force recommendations for breast cancer screening?
- The Canadian Task Force on Preventive Health Care (CTFPHC) recommends that patients and clinicians openly talk about benefits and harms of screening mammography so patients can make decisions based on their preferences and values. This is known as shared decision-making.
- For women* ages 40 to 49, the CTFPHC recommends against screening. The CTFPHC recommends shared decision-making if a woman is interested in getting screened. If they choose to be screened, they should have access to mammography.
- For women ages 50 to 74, the CTFPHC recommends screening every 2–3 years. We recommend shared decision-making with all women to discuss whether screening aligns with their preferences and values.
- The United States Preventive Services Task Force (USPSTF) recommends screening all women every 2 years starting at age 40 and up to age 74.
- Who do these recommendations apply to?
- Cisgender women who are not at high risk.
- Those who have no family history of breast cancer.
- Cisgender women and people assigned female at birth who are at average risk of breast cancer.
- Those with a family history of breast cancer or other risk factors, such as having dense breasts.
Both recommendations are for screening, so they do not apply to those with any symptoms of breast cancer (e.g., a lump). They also do not apply to high-risk individuals (e.g., those with previous breast cancer or certain genes).
- Why are the Canadian and US recommendations different?
- They deal with different populations. For example, the CTFPHC recommendations do not include those with a family history of breast cancer whereas the USPSTF recommendation does.
- They deal with different health care systems.
- They place different emphasis on shared decision-making. The CTFPHC recommendations includes shared decision-making for women of all ages. The USPSTF suggests discussing personalized guidance on screening mainly for individuals outside their recommendation’s age range (before 40 or after 74).
- Will Canadian recommendations change?
The CTFPHC monitors new evidence annually. Guidelines are scheduled for review every 5 years. In early 2023, the CTFPHC launched an update to the 2018 guideline. New evidence may result in changes.
- Was equity considered in Canadian clinical practice guidelines?
Yes, the CTFPHC incorporates an equity lens in its guideline development process. For more information, review our methods and scoping review on equity considerations in guideline development.
*Those who have female-specific breast tissue and/or hormonal profile.