In December 1992, the federal government
launched the first phase of the Canadian Breast Cancer Initiative
(CBCI) with stable, ongoing funding of $25 million over five years.
In June 1998 the renewal of the CBCI with stable, ongoing funding
was announced. This renewal resulted from extensive consultations
with breast cancer partners
and stakeholders. A key goal of the renewed CBCI has been to take
the knowledge gained and the cooperative spirit developed
during
the initiative's first phase and use these to strengthen the
CBCI's collaborative and multidisciplinary approach to breast
cancer issues. As a result, Health Canada continues to support the
activities of the National Committee for the Canadian Breast Cancer
Screening Initiative.
Although the Canadian recommendation for
breast cancer screening articulated in 1988 was that
“…women aged 50 to 69 be offered, and encouraged to
participate in, an early detection program consisting
of mammography, physical examination of the breast by a health care
professional, and teaching and monitoring of breast
self-examination every 2 years"8, organized breast
cancer screening programs continue to adapt and enhance their
practices as new evidence and technol-
ogies become available.
In 2001, the Canadian Task Force on Preventive Health Care reviewed the evidence surrounding breast self-examination (BSE). It concluded that, because there is fair evidence of no benefit and good evidence of harm, there is reasonable support to recommend that routine teaching of BSE be excluded from the periodic health examination of women aged 40 to 699. While these recommendations have been controversial, organized breast cancer screening programs recognize the importance of evidence-based screening policy. Consequently, the practice of monthly BSE is no longer routinely taught as part of a screening examination. Instead, general breast health awareness is encouraged.
Table 1
Breast cancer screening programs in
Canadaa –
usual practices, 1999 and 2000 screen years
Program |
Program |
Clinical Breast |
Program Practices for Women Outside the 50 to 69-year Age Group |
||
Age Group |
Accept |
Recall |
|||
British Columbia |
1988 |
No |
<40 |
Yesb |
None |
40-49 |
Yes |
Annual |
|||
70-79 |
Yes |
Biennial |
|||
80+ |
Yesb |
None |
|||
Yukon |
1990 |
No |
40-49 |
Yes |
None |
70+ |
Yes |
None |
|||
Northwest Territories |
1994 |
No |
40-49 |
Yes |
Annual |
70+ |
Yes |
Biennial |
|||
Alberta |
1990 |
No |
40-49 |
Yes |
Annualc |
70-74 |
Yes |
Biennial |
|||
75+ |
Yes |
None |
|||
Saskatchewan |
1990 |
No |
40-49 |
No |
N/A |
70-75 |
Yes |
Biennial |
|||
> 75 |
Yes |
None |
|||
Manitoba |
1995 |
Nurse or technologist |
40-49 |
Nod |
Biennial |
70+ |
Nod |
None |
|||
Ontario |
1990 |
Nurse |
40-49 |
No |
N/A |
70-74 |
Yes |
Biennial |
|||
75+ |
Yes |
None |
|||
Quebec |
1998 |
No |
40-49 |
Yese |
None |
70+ |
Yese |
None |
|||
New Brunswick |
1995 |
No |
40-49 |
Yesb |
None |
70+ |
Yesb |
None |
|||
Nova Scotia |
1991 |
Technologist |
40-49 |
Yes |
Annual |
70+ |
Yes |
Biennial |
|||
Prince Edward Island |
1998 |
Technologist |
40-49 |
Yes |
Annual |
70-74 |
Yes |
Biennial |
|||
Newfoundland |
1996 |
Nurse |
40-49 |
No |
N/A |
70-74 |
Yes |
Biennial |
|||
aNunavut has not developed an organized breast cancer screening program. bAccept with physician referral. cUntil April 1999 recall was biennial. dAs of July 1998, both age groups accepted to mobile unit with a doctor's referral. eAccept with physician referral if done at a program screening centre, but is not officially considered within the program. |
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