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

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APPENDICES

Appendix A: Contributing Organized Breast Cancer Screening Programs

Breast Screening Program of Newfoundland and Labrador

St. John's: (709) 777-5070
Gander: (709) 256-5597
Corner Brook: (709) 634-8558
Toll Free: 1-800-414-3443

Nova Scotia Breast Screening Program

www.breastscreening.ns.ca
1-800-565-0548

Prince Edward Island Breast Screening Program

Health and Wellness
P.O. Box 3000, Summerside, PEI: C1N 2A9
1-888-592-9888

New Brunswick Breast Cancer Screening Services

New Brunswick Cancer Network (New Brunswick Department of Health)
P.O.Box 5100, 2^nd Floor HSBC Place, 520 King Street
Fredericton, New Brunswick, E3B 5G8

Programme québécois de dépistage du cancer du sein

Ministère de la Santé et des Services sociaux du Québec
www.msss.gouv.qc.ca/sujets/santepub/pqdcs/index.php?accueil

Ontario Breast Screening Program: A Cancer Care Ontario Program

www.cancercare.on.ca
1-800-668-9304

Manitoba Breast Screening Program: CancerCare Manitoba

25 Sherbrook Street: Unit 5
Winnipeg, Manitoba R3C 2B1
(204) 788-8633 / 1-800-903-9290
www.cancercare.mb.ca/mbsp

Screening Program for Breast Cancer:
A Program of the Saskatchewan Cancer Foundation
South Saskatchewan: 1-800-667-0017
North Saskatchewan: 1-800-567-7271

Alberta Health Services

Alberta Breast & Cervical Cancer Screening Programs
Health Promotion, Disease and Injury Prevention
Population and Public Health – Alberta Health Services
Holy Cross Site: 2202-2^nd Street S.W.
Calgary, Alberta, T2S 3C1
www.screeningforlife.ca

The BC Cancer Agency's Screening Mammography Program

Vancouver, British Columbia
Phone: (604)-877-6187 (Lower Mainland),
1-800-663-9203 (Rest of British Columbia)
www.smpbc.ca

Breast Screening Program: Stanton Territorial Health Authority

Northwest Territories
Yellowknife, Northwest Territories
Phone: (867) 873-0452
Fax: (867) 873-2109
www.srhb.org/services/contact_program.php?id=10

Appendix B: Database Management Committee of the CBCSI

This Committee advises on the content, management process, and use of the Canadian Breast Cancer Screening Database. It is responsible to the National Committee for the Canadian Breast Cancer Screening Initiative, and is advisory to the Centre for Chronic Disease Prevention and Control, Public Health Agency of Canada.

Dr. Rene Shumak [Chair]

Ontario Breast Screening Program
Regional Radiology Coordinator
Greater Toronto Region
100 Sheppard Ave. East #140
Toronto, Ontario, M2N 6N5

Johanne Albert

Coordonnatrice
Programme québécois de dépistage du cancer du sein
Unité de prévention clinique
Direction de la prévention des maladies chroniques et des traumatismes.
1075 chemin Ste-Foy, 11^ième étage
Québec, Québec, G1S 2M1

Dr. Judy Caines

Medical Director
Nova Scotia Breast Screening Program
QE2 Health Science Centre: Dickson Building: Room 3036A
1278 Tower Road
Halifax, Nova Scotia, B3H 1B3

Marcia Campbell

Program Coordinator, Breast Screening Program
Stanton Territorial Health Authority
550 Byrne Road, PO BOX 10
Yellowknife, North West Territories, X1A 2N1

Dr. K.A. Canil

Chief of Surgery
Department of Health and Social Services: Qikitani General Hospital
P.O. Box 1000 Station 1036
Iqaluit, Nunavut, X0A 0H0

Christina Chu

Biostatistical Analyst
Surveillance and Outcomes Unit, Population Oncology
British Columbia Cancer Agency
801-686 West Broadway
Vancouver, British Columbia, V5Z 1G1

Gregory Doyle

Coordinator
Breast Screening Program for Newfoundland & Labrador
35 Major's Path, Suite 102
St. John's, Newfoundland, A1A 4Z9

Sangeeta Gupta

Manager
Screening Program for Breast Cancer: Population Health Division
952 Albert Street
Regina, Saskatchewan, S4R 2P7

Heather Limburg

Epidemiologist
Public Health Agency of Canada
9^th Floor, 785 Carling Avenue
Ottawa, Ontario, K1A 0K9

Brenda Mitchell

Director of Preventive & Screening Operations
Cancer Care Ontario
18-505 University Avenue
Toronto, Ontario, M5G 1X3

Dr. Laura McDougall

Medical Lead
Alberta Breast & Cervical Cancer Screening Program: Alberta Health Service,
2202-2^nd Street SouthWest
Calgary, Alberta, T2S 3C1

Jay Onysko

Manager
Public Health Agency of Canada
9^th Floor, 785 Carling Avenue
Ottawa, Ontario, K1A 0K9

Lisa Pogany

Epidemiologist
Public Health Agency of Canada
9^th Floor, 785 Carling Avenue
Ottawa, Ontario, K1A 0K9

Norah Smith

Coordinator
PEI Breast Screening Program: Queen Elizabeth Hospital:
Dept. of Diagnostic Imaging
P.O. Box 6600, 60 Riverside Drive
Charlottetown, Prince Edward Island, C1A 8T5

Sandy Williamson

Manager, Program Operations
Manitoba Breast Screening Program
5-25 Sherbrook Street
Winnipeg, Manitoba, R3C2B1

Dr. Bin Zhang

Epidemiologist
New Brunswick Cancer Network: Department of Health
P.O.Box 5100
2^nd Floor, 520 King Street
Fredericton, New Brunswick, E3B 5G8

Appendix C: Technical Sub-Committee of the CBCSI

This Committee develops and implements the strategies for the uniform collection and sharing of data in the Canadian Breast Cancer Screening Database. It is responsible to the Database Management Committee, and is advisory to the Centre for Chronic Disease Prevention and Control, Public Health Agency of Canada.

Heather Limburg [Chair]

Epidemiologist
Screening and Early Detection: Public Health Agency of Canada
9^th Floor, 785 Carling Avenue
Ottawa, Ontario, K1A 0K9

Riaz Alvi

Provincial Leader, Epidemiology
Saskatchewan Cancer Agency
4-2105 8^th Street East
Saskatoon, Saskatchewan, S7H 0T8

Jassy Anthony

Systems Analyst: Applications Division
Information Management, Information Technology Directorate
Public Health Agency of Canada
130 Colonnade Road
Ottawa, Ontario, K1A 0K9

Natalie Biswanger

Data Analyst
Manitoba Breast Screening Program: CancerCare Manitoba
5-25 Sherbrook Street
Winnipeg, Manitoba, R3C 2B1

Marcia Campbell

Program Coordinator, Breast Screening Program
Breast Screening Program: Stanton Territorial Health Authority
550 Byrne Road, PO BOX 10
Yellowknife, Northwest Territories, X1A 2N1

Christina Chu

Biostatistical Analyst
Surveillance and Outcomes Unit, Population Oncology
British Columbia Cancer Agency
801-686 West Broadway
Vancouver, British Columbia, V5Z 1G1

Theresa Comeau

Programmer
Information Technology Services: New Brunswick Department of Health P.O.Box 5100
7^th Floor HSBC Place, 520 King Street Fredericton, New Brunswick, E3B 5G8

Charles Dendy

Senior Technical Analyst: Operations Division
Information Management, Information Technology Directorate
Public Health Agency of Canada
130 Colonnade Road
Ottawa, Ontario, K1A 0K9

Kurt Combden

Project Manager: Portfolio Management Office
Information Management, Information Technology Directorate
Public Health Agency of Canada
130 Colonnade Road
Ottawa, Ontario, K1A 0K9

Meghan Duncan (past member)

Data Analyst
Manitoba Breast Screening Program: CancerCare Manitoba
5-25 Sherbrook Street
Winnipeg, Manitoba, R3C 2B1

Gregory Doyle

Coordinator
Breast Screening Program for Newfoundland and Labrador
35 Major's Path, Suite 102
St. John's, Newfoundland, A1A 4Z9

Theresa Foley

Program Manager
Nova Scotia Breast Screening Program
7001 Mumford Rd, Unit 603L
Halifax, Nova Scotia, B3L 2H8

Song Gao

Senior Statistical Analyst
Screening Programs: Alberta Health Services
2202-2^nd Street South West.
Calgary, Alberta, T2S 3C1

Solly Johnson (past member)

Systems Analyst: Application Development and Support Section
Public Health Agency of Canada
130 Colonnade Road

Usha Krishnan (past member)

Systems Analyst: Application Development and Support Section
Public Health Agency of Canada
130 Colonnade Road
Ottawa, Ontario, K1A 0K9

André Langlois

Scientifique de recherche
Institut national de santé publique du Québec:
Direction des systèmes de soins et services et maladies chroniques
945 Wolfe, 5^ième étage
Ste-Foy, Québec, G1V 5B3

Farid Maswood

Systems Analyst: Applications Division
Information Management, Information Technology Directorate
Public Health Agency of Canada
130 Colonnade Road
Ottawa, Ontario, K1A 0K9

Vicky Majpruz

Senior Research Associate: Quality Determinants, Policy and Planning
Prevention and Screening: Cancer Care Ontario
505 University Avenue
Toronto, Ontario, M5G 1X3

Jay Onysko

Manager
Screening and Early Detection: Public Health Agency of Canada
9^th Floor, 785 Carling Avenue
Ottawa, Ontario, K1A 0K9

Lisa Pogany

Epidemiologist
Screening and Early Detection: Public Health Agency of Canada
9^th Floor, 785 Carling Avenue
Ottawa, Ontario, K1A 0K9

Norah Smith

Program Coordinator
PEI Breast Screening Program
P.O. Box 6600, 60 Riverside Drive
Charlottetown, Prince Edward Island, C1A 8T5

Appendix D: Glossary

Asymptomatic

A woman who does not report symptoms and appears without signs of disease.

Breast cancer

Includes malignant invasive and ductal carcinoma in situ (DCIS) of the breast.

Clinical breast examination (CBE)

A physical examination of the breasts performed by a trained health professional.

Core biopsy

A needle biopsy of the breast used to remove samples of tissue for microscopic evaluation. Most core biopsies are image guided.

Definitive diagnosis

Definitive diagnosis of cancer is the first core or open surgical biopsy that confirms cancer. In rare occasions fine needle aspiration (FNA) biopsy may also be used as a definitive diagnosis of cancer. Definitive diagnosis of benign cases is the last benign test up to 6 months following an abnormal screen.

Ductal carcinoma in situ (DCIS)

A non-invasive tumour of the breast, arising from cells that involve the lining of a breast duct. The cells have not spread outside the duct to other tissues in the breast. DCIS is also referred to as stage 0 cancer.

Fine-needle aspiration biopsy

A needle is inserted into a lesion and cells are drawn out using a syringe. The cells are stained and examined by a cytologist in a laboratory to determine if there are any malignant cells.

Initial screen

The first screening mammogram provided to a women by a Canadian organized breast screening program.

Interval cancer

Any invasive breast cancer diagnosed during the interval between a normal screen or benign diagnostic test and before the next scheduled screening examination.

Invasive cancer

Cancerous cells invading beyond the basement membrane of the milk duct or lobule. A ductal carcinoma in situ component may also be present in cases of invasive cancer. Invasive cancer includes stage I-IV.

Normal screening episode

A screening episode that concludes with normal (non-cancer) findings. This includes both a normal screening mammogram and an abnormal screening mammogram with a normal (non-cancer) finding.

Open surgical biopsy

Surgical removal of a breast abnormality under local anesthesia for subsequent microscopic examination by a pathologist.

Post-screen cancer

Cancers that occur after the recommended 12 or 24 months in women who do not return for their regular annual or biennial screen respectively (non-compliant cancers) or women who become symptomatic before their next regular screen (interval cancers).

Prevalent cancer

The proportion of the population with cancer at a given point in time.

Screen

Includes mammography, or both clinical breast examination and mammography, delivered by a program.

Screening episode (completed)

A normal / negative screening episode is defined as the date of the last screen. For abnormal screens, the screening episode is completed at the date of first pathologic or cytologic (core or open surgical biopsy) diagnosis of cancer. Screening episode completion for benign cases is the last benign test up to 6 months following an abnormal screen. A "negative screening episode" can include all follow-up, provided that the end result is negative (normal).

Rescreening

Subsequent screening after the initial (first) screening under the program. This includes women who return after missing a scheduled round of screening.

Screen-detected cancer

Cancer detected as a result of a positive (abnormal) test with histologic confirmation attributed to the screening findings of the program.

Sojourn time

The time interval between the onset of detectable pre-clinical disease and symptomatic disease.

Total person-years at risk

Within a 12 or 24-month period after a negative (normal) screening episode, women are considered at risk for post-screen detected cancer. Women contribute a count in the denominator for each year or fraction of a year within the period of interest before a post-screen detected cancer or the next regular program screen.

Notes

1. Deaths from lung cancer exceed that of breast cancer among women in Canada, with 9,400 deaths expected in 2010.
2. Incidence of non-melanoma skin cancer exceeds that of breast cancer in Canada, however, rates are typically not reported due to difficulty estimating true incidence.
3. The Evaluation Indicators Working Group Report: Guidelines for Monitoring Breast Screening Program Performance: 2^nd Edition is available online at www.phac-aspc.gc.ca
4. This value is underestimated because volume counts are not provided to the CBCSD under 50 years or over 69 years of age by some programs for women.
5. Indicators for which a change in calculation methodology has occurred include participation rate (30 months), retention rate, diagnostic tests, and post-screen cancer rate resulting in benign diagnosis. Details of the alterations in calculation methods are presented in the relevant results sections.
6. Data for opportunistic screening was provided through the Ministry of Health from participating provinces and not obtained from the CBCSD. Opportunistic screening is likely overestimated due to double counting (when screening occurs in both the organized and opportunistic sectors), and incorrect categorization (a proportion of opportunistic bilateral mammograms are preformed on symptomatic women and therefore truly diagnostic).
7. Refers to all women including those who may have returned late (≥30 months) from their previous mammogram.
8. Non-compliant cancers are not included in this calculation.