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TORONTO — Federal Health Minister Mark Holland announced Tuesday he is temporarily suspending the work of the Canadian Task Force on Preventive Health Care, which has come under fire for not recommending routine breast cancer screening for women under 50.
The task force provides guidelines for primary health-care providers about screening and other prevention and early detection measures for cancers and other diseases.
Holland ordered an external expert review of the task force, which began last October, after it declined to lower the age for mammograms to 40, contradicting many expert opinions including the Canadian Cancer Society.
The external review panel has finished gathering evidence and is now finalizing its recommendations, the minister said in a statement.
“The panel will make these recommendations to the Public Health Agency of Canada to modernize the work of the Task Force and ensure it provides evidence-based clinical practice guidelines to primary care providers,” the statement said.
“This will ensure preventive health-care guidelines meet the needs of Canada’s health-care system and support the well-being of Canadians.”
Given the concerns expressed by experts and the public, Holland said he has asked the Public Health Agency of Canada to “pause” the group’s work in the meantime.
Last May, the task force said it maintained its advice that routine breast cancer screening start at age 50 and end after age 74.
However, it said women in their 40s could seek a mammogram after weighing the pros and cons of early screening, ideally in consultation with their health-care provider.
A spokesperson for the task force said last year that potential harms included false positives, which could lead to unnecessary painful biopsies, as well as “overdiagnosis,” which puts a burden on patients and the health-care system for cancers that wouldn’t have caused any harm if left untreated.
But many experts — and the health minister himself — have countered that most women would risk getting a false positive rather than delay a potential need for treatment.
Some provinces, including Ontario and British Columbia, publicly fund mammograms for women age 40 to 49. Alberta funds them starting at age 45.
Dense Breasts Canada and Breast Cancer Canada quickly issued statements applauding the minister’s move, saying the task force’s recommendations don’t reflect the latest scientific evidence.
Dense Breasts Canada said it has been pushing for “revision of the dangerous breast screening guidelines” for seven years.
“Through four health ministers, DBC has consistently pushed for action on outdated and biased guidelines that limit access to lifesaving screenings and fail to incorporate expert input and the latest scientific evidence,” it said.
Kimberly Carson, CEO of Breast Cancer Canada, said breast cancer rates are rising in younger populations.
“We must take every possible step to ensure that screening guidelines reflect the realities of patient needs,” Carson said in her statement.
“This pause presents a critical moment for progress, and we stand ready to support solutions that will improve breast cancer care across Canada.”
But a statement from the Canadian Task Force on Preventive Health Care said the suspension of its work “could jeopardize” other screening and prevention guidelines that are nearing completion.
“In addition to breast cancer screening, guideline topics in late-stage development include recommendations on tobacco cessation, screening for adult depression and depression in children and youth, and cervical cancer screening,” the statement said.
It said the pause will also affect ongoing work on guidelines for lung cancer and prostate cancer screening and fall prevention in older adults.
“The task force has been very much anticipating the insights and recommendations of the external expert review panel on how to improve guideline development to support clinicians and the health of Canadians,” Dr. Guylene Theriault, the task force’s chair, said in the statement.
“We welcome their recommendations which may take time to implement, but are surprised by this announcement from the minister.”
The Canadian Cancer Society acknowledged the importance of the task force’s work in a statement Tuesday afternoon, but also welcomed Holland’s move as “an unfortunate but necessary disruption before implementing the review panel’s recommendations.”
“We hope that when the task force resumes its role, it has a stronger focus on patient voices, greater inclusion of subject matter experts, and increased capacity to meet the demands placed on it,” said Brandon Purcell, the cancer society’s advocacy manager of prevention and early detection.
This report by The Canadian Press was first published March 4, 2024.
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
Nicole Ireland, The Canadian Press