Concerns about the upcoming Spring 2024 breast screening guidelines.
The Canadian Task Force on Preventive Health Care (Task Force) is currently updating Canada’s breast cancer screening guidelines. Dense Breasts Canada is concerned that the guideline update process lacks accountability, transparency, scientific rigour, equity, objectivity, and credibility.
The concerns below have been brought to the attention of senior officials in Health Minister Mark Holland's office and the Public Health Agency of Canada. Time is of the essence to correct the flawed process. Canadian lives depend on it.
Will the government take accountability and ensure the safety of Canadians? Canadians deserve guidelines based on current science and our diverse population.
Please read our concerns in the FAQ below and consider adding your voice by emailing Minister Holland
Summary of Dense Breast Canada's concerns.
- The Task Force panel has interfered with the evidence review group by dictating old studies (RCTs) from the 1960s to 1980s be included in the evidence review.
- The Task Force panel shows a poor understanding of the science as seen by their insistence on using old studies. These studies were conducted under conditions that are not reflective of modern cancer detection and treatment. One of the studies is corrupted.
- The Task Force continues to undervalue the demonstrated benefits of screening, and overemphasize so called "harms."
- Systemic racism is an issue due to the use of old studies that had predominantly white participants.
- Some provinces have lost confidence in the Task Force decisions and are making their own guidelines based on current evidence, leading to different practices across the country.
- There is silo-ing of information due to the use of multiple evidence review centres in the guideline making process.
- The Task Force is an arms length, independent body. However, it is missing a governance mechanism to oversee its procedures and ensure the well-being and safety of Canadians.
- The leaders of the Task Force appear to be biased. They seem to have a strong opinion against screening. They announced the result of the update before reviewing the evidence. Publicly, they said there's no need to change the guidelines from 2018.
- Similar concerns about the Task Force are held by various other specialties and can be read about here
- Implement an accountability structure and governance mechanisms.
- Allow breast cancer screening experts and patients to vote on the final guidelines.
- Improve transparency of the entire review process.
- Address the bias and impartiality of Task Force leadership
- Address gender and racial bias in the evidence review process and working group.
- Change the weighting of the evidence to emphasize more modern evidence that includes a diverse population.
- Address silo-ing from evidence review centres.
- Allow input from the public on the draft guideline as the US did.
This recent program by CBC Radio White Coat, Black Art has additional information. Listen here
In addition to breast cancer screening, many other specialties have similar concerns about their guidelines and have formed Responsible HealthCare Guidelines (RHG).
RHG is a coalition of concerned healthcare professionals and patients with a mission to advocate for evidence-based policies and practices that prioritize the well-being of patients. Specialty areas are voicing concerns re the Task Force guidelines in these areas: prostate cancer screening, cervical cancer screening, postpartum depression, HCV screening, lung cancer screening and ophthalmology.
You can read the briefing note here
Concerns about the current 2018 Guidelines.
Did you know the current 2018 Canadian breast cancer screening guidelines are misleading, dangerous and based on flawed studies?