provinces that don't screen women in their 40s, have higher rates of advanced breast cancers
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on average, 78 canadian women will be diagnosed with breast cancer every day and 15 will die. getty
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an alarming new study led by university of ottawa professors reveals that provinces that do not screen women in their 40s, like ontario, have higher rates of advanced breast cancers in women diagnosed in their 40s and 50s.
later-stage diagnoses mean harsher treatments — and unnecessary death —because of outdated guidelines for breast cancer screening, the hill times reports. these are the same guidelines the u.s. congress deemed too dangerous for american women.
“this is the first canadian study to show that screening policies for women 40 to 49 impact women 50 to 59,” co-lead author dr. anna wilkinson said in a news release. “women who are not screened in their 40s are presenting with later stage breast cancer in their 50s. this means more intensive treatment and a worse prognosis for these women than if their cancers were diagnosed at an earlier stage.”
canadian screening guidelines were changed in 2011
canadian breast cancer screening guidelines were changed in 2011 to recommend against screening women 40 to 49, and provinces and territories have different policies in place for screening — despite evidence that early detection of breast cancer leads to improved survival rates, the authors note.
for the study, the researchers reviewed the data of 55,490 women between the ages of 40 to 49 and 50 to 59 from the canadian cancer registry who were diagnosed with breast cancer between 2010 and 2017. they then evaluated the impact of the 2011 guidelines by looking at changes in the incidence of breast cancer by stage of severity from 2011 to 2017.
the picture is bleak when you realize the system is failing women.
there has been a 13.6 per cent decrease in incidence of stage 1 breast cancer and a 12.6 per cent increase in stage 2 for women in their 40s. for women in their 50s, the incidence of stage 2 breast cancer rose by 3.1 per cent. in provinces that did not continue to have organized screening programs for women 40 to 49, there was a 10.3 per cent increase in stage 4 breast cancer in women 50 to 59 over the six years.
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as the researchers confirm, survival rates decrease in relation to the more advanced stage of breast cancer at diagnosis. the numbers are sobering: the five-year survival rate for stage 1 breast cancer is 99.8 per cent compared to 23.2 per cent for cancers diagnosed by stage 4. these outcomes can lead to more advanced cancer, intensive treatments and surgeries, and increased mortality.
breast cancer is the most common cancer in canadian women, excluding non-melanoma skin cancers, and the second leading cause of death from cancer in canadian women. breast cancer can also occur in men, but it’s not common, says the canadian cancer society.
what do the numbers look like in 2022? the canadian cancer society estimates 28,600 canadian women will be diagnosed with breast cancer, which represents 25 per cent of all new cancer cases in women in 2022. and 5,500 canadian women will die from breast cancer, which is 14 per cent of all cancer deaths in women in 2022.
on average, 78 canadian women will be diagnosed with breast cancer every day and 15 will die from it every day.
earlier screening and detection make a difference. in fact, a report by university of british columbia researcher dr. paula gordon and colleagues, confirmed significant flaws in the study that shaped current breast cancer screening guidelines.
the report, published in the journal of medical screening in 2021, revealed methodology errors in two canadian trials, which found mammograms for women in their 40s did not reduce death rates from breast cancer. gordon said in a news release on the findings, “it is heartbreaking to know that women’s lives have been lost due to the influence of these flawed studies on screening policies.”
current study is a wake-up call for policymakers and the public
“our findings align with recently updated usa national comprehensive cancer network guidelines that recommend annual screening mammography for average risk women beginning at age 40,” dr. jean seely, faculty of medicine professor and head of breast imaging at the ottawa hospital, said in the release.
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when it comes to breast cancer, your health may depend on where you live – and what you’re willing to advocate for. as the university of ottawa release notes, the provinces and territories that used annual screening reminders for women in their 40s during the study period were british columbia, alberta, northwest territories, nova scotia and prince edward island. currently, only nova scotia, prince edward island and yukon provide annual reminders.
karen hawthorne is a toronto-based writer.
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