Organized Breast Cancer Screening Programs in Canada - 1996 Report

Breast Cancer Screening in Canada

In March 1988, 28 representatives from government and key voluntary and professional groups from across Canada participated in the National Workshop on the Early Detection of Breast Cancer. The purpose of the workshop was to develop a Canadian position on breast cancer screening.⁶

Based on presentations and discussions of the evidence supporting breast cancer screening, the following recommendation was made: Canadian women aged 50 to 69 should be offered and encouraged to participate in an early detection program consisting of mammography, physical examination of the breasts by a health care professional, and the teaching and monitoring of breast self-examination every 2 years. Such a program should be offered through dedicated screening centres.⁶

Dedicated screening centres were recommended because they were identified as the best way to ensure identification and recruitment of the target group, standardization, quality control, appropriate follow-up of women with abnormal findings, and lowest unit cost. In the workshop report, the essential components of a dedicated screening centre are described.⁶ Of particular importance are procedures for identification and recruitment of the target group, an effective referral system once an abnormality has been detected, and procedures for evaluating and monitoring the programs. These recommendations were endorsed by the Conference of F/P/T Deputy Ministers of Health in December 1988.

In December 1992, the federal government announced the Canadian Breast Cancer Initiative (CBCI), with a total budget of $25 million over 5 years. One of the first events was the National Forum on Breast Cancer, held in November 1993. The goal of the Forum was to identify priorities to be addressed in the areas of breast cancer research, prevention and screening, treatment and care, and networking and advocacy. In the area of screening, one of the recommendations was as follows: To ensure that mammography screening in all provinces and territories is carried out within the context of an organized program which has the following essential components: a population-based outcome goal, information about the target population, special emphasis on hard-to-reach groups (including rural communities), meticulous quality assurance, including equipment and interpretation, outcome data and analysis, information systems and linkages, a woman-centred focus and excellent coordination, with high quality diagnosis and follow-up.⁷ In addition, it was recommended that a national database derived from mammographic screening programs across the country be developed and maintained to allow monitoring and evaluation of breast cancer screening in Canada.⁷

On the basis of the recommendations of the Forum, the Canadian Breast Cancer Screening Initiative (CBCSI), one of the six programmatic components of the CBCI, was structured and is active in providing support and coordination for organized breast cancer screening programs in Canada. As well, it was with the support of the CBCSI that the Canadian Breast Cancer Screening Database was established.

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