Research Activities Using the CBCSD

In addition to its primary use in evaluating and monitoring the effectiveness of organized breast cancer screening programs in Canada, the CBCSD is proving to be a valuable tool to carry out research and to support policy development on issues related to breast cancer screening.

The CBCSD has supported activities of the Working Group on the Integration of Screening and Diagnosis sponsored by the Canadian Breast Cancer Screening Initiative National Committee. This working group was mandated to evaluate the current diagnostic process after an abnormal breast screening examination for Canadian women, and, if gaps were identified, propose steps to achieve timely and well-coordinated links between screening and assessment. Nationally, half of all women aged 50 to 69 who had a screen-detected abnormality waited nearly 4 weeks from their screening exam to obtain a diagnosis. Requiring a biopsy substantially increased the time required to reach a diagnosis (Figure 3). Taking into consideration factors such as the timeliness already achieved for half the women attending organized screening programs in Canada, the working group recommended timeliness targets for Canadian organized breast screening programs. A full report of the group's findings and recommendations was produced in 2000¹⁴. It can be accessed at the following website: http://www.phac-aspc.gc.ca/ccdpc-cpcmc/bc-cds/pub_e.html.

Figure 3 Duration from abnormal screen to diagnosis among women aged 50-69 requiring follow-up, 1996

Notes: Evaluated with data from B.C., Alta., Sask., Man., Ont., N.S., and Nfld. Cutoffs indicate the point at which 10%, 25%, 50%, 75% and 90% of women have received a diagnosis.

In October 1999, more than 30 representatives from provincially organized breast cancer screening programs, the academic research community and Health Canada convened at a workshop held in Ottawa to reach consensus on priority research activities to be undertaken by the CBCSD. Projects that ranked highly and for which preliminary research plans were developed include the following: to evaluate the benefit of clinical breast examination in addition to mammography; to measure the occurrence of post-screen detected cancers; to assess strategies to increase recruitment and retention; and to determine the impact of screening on breast cancer incidence and mortality. Projects have been initiated in each of these priority areas.

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