Canadian doctors are using 'outdated' guidelines to screen for cancer, experts warn

Carolyn Holland can't help wondering how many years of her life she's lost because her breast cancer was diagnosed late.

The Ottawa mom first discovered lumps in her breasts while in the shower. At 43 years old, she'd never had a mammogram.

After seeing her doctor, she was sent for a screening, which confirmed the cancer. But at that point it had already advanced. Holland needed two types of chemotherapy, radiation, the removal of her lymph nodes and a double mastectomy.

"This shouldn't happen to other women. It's preventable," Holland said.

Holland's doctors told her that her treatment could have been less drastic had the cancer been detected sooner. But Canada's national guidelines do not recommend routine breast cancer screening for women under the age of 50.

"Had I been able to access screening at 40, this wouldn't have been my outcome," she said.

A group of medical experts say Canadian lives are at risk because family doctors are using outdated guidelines to decide whether, and when, to send their patients for routine cancer screenings.

The guidelines are issued by the Canadian Task Force on Preventive Health Care, an arms-length panel of 15 doctors and other primary care providers set up by the federal government. The independent volunteer panel examines the research on screening and preventing various illnesses, including cancer.

"These guidelines impact millions of Canadians. The consequences are grim. Current task force guidelines often limit access to critical life-saving screening," said Dr. Shiela Appavoo, an Edmonton-based radiologist.

She's with the Coalition for Responsible Healthcare Guidelines, a group of cancer specialists, family doctors and patients calling for changes to how the guidelines are created.

The coalition says the task force is using outdated research, doesn't properly take in the advice of experts and is far too slow to update its recommendations.

The task force's breast cancer screening guidelines are set to be updated next month. The current recommendations, last updated in 2018, recommend against broad screening of women in their 40s.

The Canadian Cancer Society withdrew its support for the guidelines in December 2022, citing concerns that they were not keeping pace with new research, in particular the growing incidence of cancer in younger populations around the world. The latest statistics show the cancer most commonly diagnosed in Canadians aged 30 to 49 is breast cancer.

Many provinces have ignored the task force guidelines by lowering the age when they offer breast cancer screening to include women in their 40s.