Breast cancer is the most common cancer among Canadian women. Mammographic screening in women aged 50 to 69 years has been shown to reduce the rate of death from breast cancer by up to 40%. In 1988, the Conference of F/P/T Deputy Ministers of Health endorsed the recommendations from a National Workshop on the Early Detection of Breast Cancer that Canadian women aged 50 to 69 be offered mammography every 2 years through dedicated screening programs. In 1999, all 10 provinces and the Yukon have organized screening programs, and the Northwest Territories is in the process of implementing such a program.
This document is the first of a series of biennial reports on organized breast screening programs in Canada, using data from the Canadian Breast Cancer Screening Database. Data from the 1996 calendar year for seven provincial programs are presented. The number of screens occurring within organized screening programs has increased dramatically in the past decade; in 1996 there were 310,359 screens of 310,036 women in seven provinces. Despite the increase, recruitment of women in the target age group (50 to 69 years) remains a challenge. Participation rates within programs ranged from 10.6% to 54.2%. It is suggested that regular attendance by a minimum of 70% of women in the target age group is needed before a screening program will have its optimal effect on breast cancer death rates.
Aside from participation rates, program outcomes compare favourably with international standards. Breast cancers are being detected at a small size, when the prognosis is good. Among women aged 50 to 69, 51.8% of invasive cancers were less than 15 mm in diameter, and 76.6% of invasive cancers did not have lymph node metastases.
Future directions include ongoing expansion of organized screening within provinces and territories, and increased efforts to encourage participation of women within the target age group. Monitoring and evaluation of organized breast cancer screening in Canada will continue, with a biennial report of 1997/98 results planned for the year 2000. As well, representatives of organized programs are in the process of setting priorities for future research efforts in organized breast cancer screening.
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