Report finds urgent gaps in Canadian breast cancer care

A new report by Breast Cancer Canada (BCC) reveals gaps and inconsistencies prevalent in Canada’s health-care system when it comes to treatment and diagnosis of people with breast cancer. 

As Breast Cancer Awareness Month comes to an end, BCC, a national non-profit charity, released a first-of-its-kind progress report on breast cancer in Canada. 

The report highlights “urgent” gaps including inconsistent screening guidelines, lack of timely access, and how patients are affected by financial burdens. 

CEO Kimberly Carson says BCC is “looking at creating [better] standards of care for patients across the country.”

She says the best way to do so is to have provincial governments listen to BCC experts when creating standard guidelines for treating and diagnosing the disease.

The report shows a lack of consistency across provinces for standard breast cancer screening guidelines – including the minimum age for a self-referral to a clinic.

In most provinces, patients can get screened for breast cancer without a doctor’s referral by the age of 40. However, in Alberta and the Northwest Territories, the age for self-referral is 45. In Quebec, it’s 50. 

Carson says Canada has fallen behind other G7 countries in terms of age for treatment. While other countries have a standardized age of 40, the Canadian government has not lowered the age across provinces. 

“Vancouver’s had the age lowered to 40 for a number of decades… and now some of the other provinces are following suit. So we applaud those bold efforts to make better access for Canadians when we see that the age of diagnosis is certainly starting to be on a lower and lower age bracket,” said Carson.

BCC says inconsistencies have led to delays in early detection for breast cancer. Delays affect women under the age of 50 in particular, where there appears to be a rise in breast cancer diagnosis. 

A BCC poll revealed 94 per cent of Canadians supported lowering the minimum screening age to 40 across the country. 

Another issue outlined in the report is how Canada lacks timely access to new treatments for breast cancer. BCC says since 2016, only five out of 20 new breast cancer treatments were funded within six months of their proposal. Once the treatments are approved by Health Canada, the organization says many new therapies get delayed by health technology assessments and provincial pricing negotiations. 

Carson explains, “If patients have to pay out of pocket for a medication that’s not available in one province but is available in another… that’s obviously frustrating for us. So if some provinces have access to certain medications and some don’t, then that really affects your treatment based on where you live in Canada. We’d like to see that standardized across the country.”

Although cancer treatment is under Canada’s Medicare plan, the Canadian Cancer Society says other financial burdens outside of health can affect treatment, including childcare, housekeeping, the cost of medicine, travel, and parking. Patients can also experience a loss of income due to time away from work.

Another poll conducted by BCC concluded that people who are diagnosed under the age of 55 are more likely to experience financial strain. BCC says it wants policy changes to alleviate financial burdens and provide better-funded health-care programs for patients. 

Overall, Carson says no province is ahead of others when it comes to breast cancer care.

“Some provinces have screening and detection at a lower age, but less access to medication. Some have a higher age. So it’s a bit of a mix-up.”

Carson says, in honour of Breast Cancer Awareness Month, BCC plans to push out more yearly reports about its current findings for breast cancer care in Canada.