ARCHIVED - Organized Breast Cancer Screening Programs in Canada - Report on Program Performance in 2005 and 2006

Executive Summary

Breast cancer is the most common type of cancer and the second leading cancer cause of death among Canadian women with a projected 23,000 diagnoses and 5,330 deaths in 2010.⁽¹⁾ Incidence rose steadily from 1980 to the early 1990's and now shows a pattern of modest decreases and increases for which the cause is unclear.⁽¹⁾ The mortality rate attributable to breast cancer has declined by 30% over the past twenty years.⁽¹⁾ Although breast cancer can occur at any age, more than half (52%) of new cases occur among women between 50 and 69 years.⁽¹⁾ Early detection, through programmatic screening, combined with effective treatment remains the best option available to continue reducing deaths from breast cancer in this age group.

The monitoring and evaluation of organized breast cancer screening programs provides an opportunity to understand the impact of screening on breast cancer morbidity and mortality, as well as the potential harms associated with screening. Systematic evaluation of organized programs helps to ensure that Canadian women have access to high-quality breast cancer screening programs. This document presents an evaluation of the performance of organized breast cancer screening programs in Canada for the calendar years 2005 and 2006 using data from the Canadian Breast Cancer Screening Database from ten provinces and one territory.

The societal benefits from breast cancer screening are based on the assumption that 70% of eligible women participate in biennial screening mammography; however, meeting this challenge remains elusive for organized screening programs across Canada. While many programs continue to see increases in participation rates, several mature programs have reached a plateau with participation rates just above 50%. When the contribution of opportunistic screening is considered, most programs report participation close to the target, however, are unable to provide associated comprehensive evaluation.

Organized breast cancer screening programs will continue to provide screening services to Canadian women in the coming years. Programs strive to achieve reductions in the morbidity and mortality associated with breast cancer through program evaluation, ongoing research, and adaptation of program policy to reflect new evidence and technologies. The Canadian Breast Cancer Screening Initiative, which supports the production of this report, provides a venue for information sharing to solve screening program challenges. The information provided in this report is available to support governments, cancer agencies, screening program managers, health professionals, and other breast cancer stakeholders to enhance organized screening across Canada.