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Organized Breast Cancer Screening Programs in Canada

1999 and 2000 Report

Breast Cancer Screening in Canada

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 Canada^a –
usual practices, 1999 and 2000 screen years

Program	Program Start Date	Clinical Breast Exam on Site	Program Practices for Women Outside the 50 to 69-year Age Group
Program	Program Start Date	Clinical Breast Exam on Site	Age Group	Accept	Recall
British Columbia	1988	No	<40	Yes^b	None
			40-49	Yes	Annual
			70-79	Yes	Biennial
			80+	Yes^b	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	Annual^c
			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	No^d	Biennial
			70+	No^d	None
Ontario	1990	Nurse	40-49	No	N/A
			70-74	Yes	Biennial
			75+	Yes	None
Quebec	1998	No	40-49	Yes^e	None
			70+	Yes^e	None
New Brunswick	1995	No	40-49	Yes^b	None
			70+	Yes^b	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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