Major overhaul ordered for group that sets Canada's cancer screening guidelines

CBC

5 hours ago

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A major overhaul is expected of the national body that issues Canada's cancer screening guidelines.
The changes were ordered by the federal health minister, following an external review of the Task Force on Preventive Health Care.
The task force is an arm's-length panel set up by the federal government to publish national guidelines for family doctors, advising them on when to send their patients for routine screenings of various illnesses, including common cancers.
But the panel has been criticized for years for failing to fully take in expert advice, using outdated research and being too slow to update its guidelines. Many of the task force's recommendations are over a decade old.
"Those cancer screenings translate into survival," said Dr. Anna Wilkinson, an Ottawa family physician who helps care for cancer patients.
"We know that technology and medical science changes so rapidly," she said. "We're not keeping pace and that's impacting people's health."
The health minister suspended the task force's work last year and ordered the review, after it came under mounting scrutiny for continuing to recommend routine breast cancer screening only start at 50 years of age.
That guideline flew in the face of evidence that screening should start at 40 — advice supported by the Canadian Cancer Society and already implemented in several provincial breast screening programs. The cancer most commonly diagnosed in Canadians aged 30 to 49 is now breast cancer.
"We know that we're seeing more and more early-age onset of breast cancer," Wilkinson said. "We need to have guidelines that are in line with those changes."
A 'pressing need'
The review calls on the task force to be more accountable and transparent, streamline and speed up its guideline updates and ensure experts are consulted, citing a "pressing need to modernize its approach."
The task force has been criticized for other recommendations, including cervical, prostate and lung cancer screening. Its guidelines on cervical cancer, for example, haven't been updated since 2013, and recommend against screening for HPV, the virus that causes cervical cancer. The U.K. and Australia replaced Pap tests with HPV screening in 2016 and 2017, respectively, because HPV can be detected much sooner.
Wilkinson said she's hopeful the major changes to how the task force operates will save lives, especially since many primary care physicians are trained to use those guidelines when deciding to refer their patients for tests.
Her own research found Canadian women who lived in provinces where breast cancer screening started at 40 had a better chance of surviving than those who were screened in their 50s.
Early screening would have changed the life of Carolyn Holland.
At 43, she discovered lumps in her breasts. By that point, the cancer had spread so aggressively that she needed chemotherapy, radiation and a double mastectomy.
A mammogram could have caught her cancer sooner, but she had never had one. Her family physician was following the task force guidelines that said she didn't need a routine screening until 50.
"Had my cancer been caught earlier with mammography at 40, my treatment and outcome would have been drastically different," Holland said.
In a statement, the task force said it looks forward to helping bring about the changes, which will "bolster the task force's credibility," adding that its work is "internationally known for its rigorous evidence-based guidelines."
"The recommendations in this report are not only about modernizing the approach but about ensuring that preventive health care remains responsive to evolving scientific evidence, inclusive of diverse perspectives, adaptable to real-world delivery settings and to local public health priorities," the statement reads.