Should breast cancer screening start at age 40? Doctors, survivors call on Canada to follow U.S. lead

An influential U.S. health panel is recommending mammograms begin 10 years earlier than the current recommendation, a move that a number of Canadian doctors and breast cancer survivors have also been demanding for years.

The U.S. Preventive Services Task Force issued a draft guidance on Tuesday calling for biannual breast cancer screenings to start at age 40. Currently, national guidelines on both sides of the border recommend screenings start at 50.

In Canada, breast cancer is the most common cancer in women and it is the second leading cause of cancer deaths. But for many Canadian women in their 40s, mammograms are often a request, not a recommendation.

The Canadian Task Force on Preventive Care — the Public Health Agency of Canada’s independent expert panel — currently recommends mammograms every two to three years for women aged 50 to 74.

For women aged 40 to 49, the task force recommends against mammograms unless they’re at an increased risk of breast cancer.

“The balance of benefits and harms is less favourable for women of this age than for older women,” the task force says on its website.

But groups like Dense Breasts Canada have been petitioning the federal health minister to begin routine mammogram testing at 40, when the cancer is often more aggressive. Some provinces are already doing routine screening for breast cancer at 40, such as B.C., P.E.I. and Nova Scotia.

Many survivors and experts say screening guidelines in Canada are antiquated and need to change.

“I see in my practice, women in their 40s who say, ‘I’ve been asking to be screened’ and they say their family doctors say ‘No, I’m not allowed to, it doesn’t meet the guidelines,'” Dr. Jean Seely, head of breast imaging at Ottawa General Hospital, told CTV National News. “And this is why we need to update these guidelines because it is harming patients and some people are dying from these guidelines.”

Sherry Wilcox was 44 years old when she found a small lump in her breast, and part of her battle was simply getting diagnosed. Her family physician said she was too young to have a mammogram and instead referred her to an ultrasound clinic.

“When we got the results back, it showed something abnormal. They didn’t seem too worried, but they did tell me to come back in 16 weeks to confirm. And I think at that point, I said, ‘That’s not good enough, I want a mammogram,'” Wilcox told CTV National News.

The Canadian Task Force on Preventive Care’s guidelines are reviewed every five years and are set to be evaluated again this year.

“I really had to fight for that mammogram and I thank myself everyday that I did advocate for myself in that way. But I can’t help thinking about others who may not be as confident in their self-advocacy,” said Wilcox.