Concerns about the 2024 draft breast screening guidelines.

The Canadian Task Force on Preventive Health Care (Task Force) has just released its draft breast cancer screening guidelines. Dense Breasts Canada remains deeply concerned that the guideline update process lacked accountability, transparency, scientific rigour, equity, objectivity, and credibility.

The concerns below were brought to the attention of senior officials in Health Minister Mark Holland's office and the Public Health Agency of Canada over the past  years. The Minister on May 30th held a press conference and expressed his concern and disappointment. He outlined a plan to review the processes, membership and evidence.

https://www.youtube.com/watch?v=qr6DSPO8zak

We hope to see 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.
  • 10/12 provinces/territories 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 about the harms of 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

 

Recommendations.

  1. Implement an accountability structure and governance mechanisms.
  2. Allow breast cancer screening experts and patients to vote on the final guidelines.
  3. Improve transparency of the entire review process.
  4. Address the bias and impartiality of Task Force leadership
  5. Address gender and racial bias in the evidence review process and working group.
  6. Change the weighting of the evidence to emphasize more modern evidence that includes a diverse population.
  7. Address silo-ing from evidence review centres.
  8. Allow input from the public on the draft guideline as the US did.

 

 

 

Concerns about the current Guidelines.

Did you know the current 2018 Canadian breast cancer screening guidelines are misleading, dangerous and based on flawed studies?

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