The following is a release from the Coalition for Responsible Healthcare Guidelines. For more background on the coalition, click HERE.
April 15, 2024
For immediate release
OTTAWA – Medical experts raised the alarm about the Canadian Task Force on Preventive Health Care at a news conference in Ottawa on Monday and called for its reform.
The task force is a federally appointed body which sets guidelines used by family doctors across Canada to determine what kind of health screening patients require. This covers recommendations on a wide range of preventive health measures, including mammograms, colonoscopies, vision checks and similar procedures which can detect cancer and other conditions early.
The Coalition for Responsible Healthcare Guidelines says that guidelines issued by the task force are developed by individuals who have no expertise or experience in the topics. The major guidelines fail to align with recommendations from experienced clinicians and scientists.
Experts in a wide range of cancers and other critical diseases – including breast, lung, prostate, and cervical cancer – say that recent decisions by the task force are putting Canadians’ lives at risk by recommending limited screening.
“The consequences are grim,” said radiologist Dr. Shiela Appavoo, “Current guidelines often limit access to critical life-saving screenings and result in later stage diagnoses of disease. Later diagnosis is associated with greater suffering, death and increased treatment costs.”
Breast screening guidelines are currently under review at the Canadian task force and an announcement is expected within weeks. In May 2023, the US Preventive Services Task Force released draft recommendations calling for screening of average-risk women in their forties. The American group said its evidence showed this would have a “moderate benefit” in reducing deaths. The U.S. task force noted Black women are 40 per cent more likely to die of breast cancer than white women, and earlier mammograms could be especially important in addressing that disparity.
“The Canadian task force appears to have a strong bias against early detection,” said Dr. Martin Yaffe, University of Toronto professor and a senior scientist at Sunnybrook Research. “They focus on 60-year-old studies and ignore modern evidence. Their advice against screening women for breast cancer before age 50 or after age 75 is resulting in as many as 700 unnecessary deaths in Canada each year, as well as suffering from harsh therapies needed when diagnosis is delayed.”
Other experts at the news conference expressed similar concerns related to their fields.
Prostate cancer is the most frequently diagnosed cancer in Canadian men and the third leading cause of death.
“Outdated task force decisions on screening often lead to late diagnoses resulting in unnecessary suffering for patients and significant costs to our healthcare system,” said Dr. Fred Saad, director of Prostate Cancer Research at the Montreal Cancer Institute/ CRCHUM. “There is an urgent need to improve strategies leading to earlier diagnosis and treatment for men at risk of suffering and early death due to prostate cancer.”
Lung cancer remains the most commonly diagnosed cancer in Canada, as well as the largest cause of cancer deaths.
“Late diagnosis is prevalent, and low dose CT screening can substantially change this and significantly improve survival,” said Dr. Paul Wheatley-Price, associate professor at the University of Ottawa faculty of medicine and past president of Lung Cancer Canada. “The task force needs to urgently update their guidelines so as not to continue to be a barrier to implementing a life saving program. Despite out-of- date task force recommendations, not supported by experts, provinces are going ahead and opening screening programs anyway as they recognize the importance.”
The Coalition for Responsible Healthcare Guidelines is calling for restructuring of the Canadian task force and reform of its guidelines. The group says an accountability structure must be created to oversee the task force’s work, and that this work must include the meaningful involvement of experienced experts and greater transparency in the development of responsible healthcare guidelines. “Lives are at stake,” said Appavoo, “It is our duty to prioritize the well-being of all Canadians.”