People should be able to get a mammogram starting at age 40 but it shouldn’t be routinely offered to women under 50 who are of average risk, new Canadian screening guidelines suggest.
Thursday’s recommendations from the Canadian Task Force on Preventive Health Care were first reported by the Globe and Mail newspaper.
The task force “does not recommend regular screenings for women under 50 who are of average risk,” a spokesperson said in an email to CBC News. “However, the task force believes breast cancer screening is a personal choice, and that any woman who wants a screening should be able to get one.”
Earlier this month, the Canadian Cancer Society called for breast screening to routinely begin at age 40, which some are moving toward.
The task force offers guidance to family physicians and their patients on screening to prevent cancer in the general population as well as other illnesses.
The arms-length panel of 15 doctors and other primary care providers was set up by the federal government.
When researchers in Ottawa compared breast cancer statistics from provinces that screened women in their 40s to data from provinces that followed the task force guidelines, they concluded earlier screening led to significantly improved survival rates.
However, the task force notes routine screening also carries the risk of harms such as unnecessary tests and anxiety.
Women aged 40 to 49 can self-refer to a breast screening program in Yukon, British Columbia, Nova Scotia, Newfoundland and Prince Edward Island, according to the Canadian Cancer Society. Ontario will start covering screening mammograms for women in their 40s this fall.
The Northwest Territories and Alberta have recently lowered program start age from 50 to 45 and Saskatchewan recently announced that it will lower its program start age to 40, using a phased-in approach beginning in 2025, the society said.
New Brunswick is also moving toward earlier screening with self-referral.
Dense breasts questions raised
The task force recommendations will be open for a 30-day comment period.
Breast cancer is a major health concern in Canada, with one in eight Canadian women diagnosed in their lifetime.
Dense Breasts Canada, a group that advocates for better screening and awareness of optimal breast screening, is disappointed in the task force recommendations.
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The breast is made up of fat and normal breast tissue composed of glands, fibrous tissues and more. Breast cancer looks white on a mammogram, as does normal breast tissue. When a woman has a larger proportion of normal dense tissue, it can be more difficult to spot cancer on a mammogram, Dr. Paula Gordon, a breast radiologist and a clinical professor in the University of British Columbia’s radiology department, said in a Dense Breasts Canada news release.
Other risk factors for breast cancer include age, a family history and genetic mutations, oncologists say.
“I’m deeply concerned that Canadians will continue to face unnecessary later stage breast cancer because of these guidelines,” Gordon said in the release.
The risk of a later stage breast cancer is a particularly urgent concern for Black women, said Dr. Ify McKerlie, principal radiologist at Calgary’s Women’s Imaging Centre.
Asian and Hispanic women are also at a higher risk of getting breast cancer earlier in life, radiologists say.