Comment: Quebec's new breast screening policy has gaps

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In a Jan. 31 policy change, the Quebec Breast Screening Program expanded its mammography screening program to include women ages 69 to 74. While this move is important progress for continued breast cancer screening, it also reflects a stark reality: Quebec still lags behind other provinces and territories in offering optimal breast cancer screening.

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Breast cancer the most commonly diagnosed cancer In women in Quebec, it is estimated 9559 cases in 2023. It remains one of the most dangerous cancers affecting women 1400 people died every year. Early detection through screening greatly increases the chance of survival. Women with mammograms 40 percent less likely to die breast cancer than women without a mammogram. Early detection can also reduce the need for serious treatment and improve patients' quality of life.

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Furthermore, the benefits of mammography screening go beyond individual health outcomes. Early detection also reduces the burden on the healthcare system by reducing the need for expensive cancer-related treatments. A 2023 reading This was proved by Canadian researchers Treatment for stage 4 breast cancer can cost more than $500,000 per patient, depending on the subtype. This equates to treatment 11 times more expensive than Phase 1 treatment.

The screening program's previous policy, which limited screening to age 69, left a significant gap in preventive care, as we know breast cancer. risk increases with age. The decision to extend screening to age 74 is long overdue, but brings Quebec into line with 11 provincial and territorial screening programs that have offered screening until age 74 for decades.

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Additionally, women in Quebec cannot continue to seek mammograms after age 74, which is contrary to Quebec. seven other jurisdictions In Canada, screening programs allow women to self-refer for mammograms after age 74, recognizing the importance of continued screening.

Quebec also lags much of the country in breast screening, which promotes early detection of breast cancer. It will be by the fall of 2024 six jurisdictions allow self-referrals at 40 — British Columbia, Nova Scotia, Prince Edward Island and the Yukon have been featured in the 40s for decades, with Ontario and New Brunswick joining them this year. Screening in Quebec only begins at age 50, although 17 percent of breast cancer cases occur in the 40s. Cancer in this age group is more aggressive, leading to increased mortality and more aggressive treatment and surgery.

Recent Canadian Research found that women in their 40s living in provinces that did not screen before age 50 were more likely to be diagnosed with stage 2, 3, and 4 cancers at age 40 than their counterparts in provinces that did screen. In addition, studies show the highest incidence of breast cancer. Cancer in the late 40s for black, Hispanic, and Asian women compared to white women in the late 50s and early 60s.

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In addition, eight jurisdictions directly inform individuals of their breast density category in the mammogram results letter sent to them. No Quebec. Seven jurisdictions recommend women with the highest density annual rather than biannual mammograms. No Quebec. There is an urgent need to address gaps in Quebec's breast cancer screening practices.

The delay in adopting optimal screening practices raises questions about the Quebec government's commitment to women's health and equal access to health services. To reduce unnecessary suffering and death, the government must prioritize the implementation of evidence-based policies that ensure equal access to preventive care. This includes allowing self-referral for screening starting at age 40 and continuing after age 74.

Quebec women deserve the same opportunity for early breast cancer detection as women in the rest of Canada. Life depends on it.

Jenny Dale is the founder and executive director of Dense Breasts Canada, an organization that advocates for optimal breast cancer screening. Annie Sleight is the Quebec Director of Advocacy and Education at DBC.

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