Breast Density Awareness Act

An Act respecting the awareness of screening among women with dense breast tissue

This bill was last introduced in the 41st Parliament, 2nd Session, which ended in August 2015.

This bill was previously introduced in the 41st Parliament, 1st Session.

Sponsor

Patrick Brown  Conservative

Introduced as a private member’s bill. (These don’t often become law.)

Status

Second reading (Senate), as of Jan. 28, 2015
(This bill did not become law.)

Summary

This is from the published bill. The Library of Parliament often publishes better independent summaries.

This enactment requires the Government of Canada to encourage the use of existing initiatives in order to increase awareness among women about the implications of heterogeneous or dense breast tissue for breast cancer screening, and to assist women and health care providers in making well-informed decisions regarding screening.

Elsewhere

All sorts of information on this bill is available at LEGISinfo, provided by the Library of Parliament. You can also read the full text of the bill.

Votes

May 9, 2012 Passed That the Bill be now read a third time and do pass.
March 14, 2012 Failed That Bill C-314, in Clause 2, be amended by adding after line 20 on page 3 the following: “( d) ensuring, through the Canadian Breast Cancer Screening Initiative, the collection, processing and distribution of information on best practices for the screening and detection of cancer in persons with dense breast tissue.”

Breast Density Awareness ActPrivate Members' Business

May 8th, 2012 / 5:30 p.m.
See context

Conservative

Patrick Brown Conservative Barrie, ON

moved that Bill C-314, An Act respecting the awareness of screening among women with dense breast tissue, be read the third time and passed.

Mr. Speaker, it gives me great pleasure to speak to Bill C-314, an act respecting the awareness of screening among women with dense breast tissue, for the final hour of debate in the House.

Bill C-314 calls on the federal government to encourage the use of existing federal initiatives in order to increase awareness among Canadian women about dense breast tissue and the implications for breast cancer screening.

Breast cancer is the most common form of cancer among women. It claims many lives, and many deaths can be avoided through screening and early detection.

This year alone about 23,000 women will be diagnosed with breast cancer and 5,000 women will die from this disease. That represents about 450 women diagnosed each week. This situation is difficult to accept. It affects women and their loved ones profoundly.

For women with dense breast tissue, breast cancer is generally harder to detect using mammography, resulting in the need for more frequent screening.

Raising awareness about dense breast tissue is important for Canadian women. Through the bill we can raise awareness of breast cancer screening for women with dense breast tissue. Greater awareness and information about dense breast tissue is a tangible way we can make a difference. It would help women and their doctors make well-informed decisions regarding breast cancer screening. For these reasons I will ask my colleagues to continue to show their support for the passage of the bill.

Bill C-314 would support a number of initiatives that the federal government already has under way to support early detection and screening of breast cancer.

As noted in the bill, the federal government plays a role in facilitating the sharing of best practices and information on screening, as well as supporting research through its programs and networks. Building on existing initiatives, the bill is focused on raising awareness in several ways.

First, the bill requires the government to determine if there are breast density information gaps in relation to breast cancer screening. Through research we can investigate the full spectrum of cancer prevention and control, including breast cancer.

In this regard, the federal government's cancer research investments through the Canadian Institutes of Health Research, or CIHR, are serving to fill some research gaps. Through the CIHR, the federal government is supporting research on more effective diagnostic treatment and prevention for all cancers, including breast cancer. In 2010-11, $171 million was spent on cancer research, and $22.7 million was spent for breast cancer research.

These research investments are supporting important scientific work. In particular, CIHR's Institute for Cancer Research is supporting research that will lead to reducing the burden of cancer on individuals and families through improved prevention efforts. It has placed a priority on research concerning early cancer detection, and it is working with partners to advance this research priority.

For instance, the institute is currently exploring partnerships with groups such as the Canadian Breast Cancer Foundation and the Breast Cancer Society of Canada, and it would include efforts in early detection as part of this focus. The institute is looking at targeted funding for research on the early detection of cancer, including breast cancer, to address information gaps. Scientific research such as this is helping to improve screening and is helping to raise awareness about the challenges related to breast cancer screening.

In addition, to raise awareness, the second element of the bill requires that approaches be identified, as needed, to improve information for women in order to, first, address the challenges of detecting cancer in women with dense tissue and, second, raise awareness concerning these challenges.

In response to the bill, the government will continue to raise awareness about breast density and its screening implications through the Canadian breast cancer screening initiative. This initiative respects the role of provincial and territorial programs and the role they play in early detection of breast cancer among Canadian women. Through it, we are working with the provincial and territorial governments to measure screening program performance nationwide and to develop better screening approaches.

The Canadian breast cancer screening initiative supports the good work already under way with our provinces and territories. By facilitating information-sharing about breast cancer screening across Canada, the initiative can achieve its goal of evaluating and improving the quality of organized breast cancer screening programs.

The Canadian breast cancer screening initiative is helping raise awareness about cancer screening, including screening for women with dense breast tissue. By building upon best practices and lessons learned, breast cancer screening programs can be improved and strengthened across the country.

The third element of the bill even more directly relates to the Canadian breast cancer screening initiative. The bill would require the existing Canadian breast cancer screening initiative to share information on dense breast tissue and its relationship to breast cancer screening and any follow-up procedures that may be necessary. The follow-up procedures are a pretty important part of this.

Sharing information about ways to improve cancer screening programs ensures women receive the full benefits of early detection, including information about all aspects of breast cancer screening.

We must sustain this collaboration and collective assessment of breast cancer screening programs. In this regard, the government has established a federal, provincial and territorial national committee for the Canadian breast cancer screening initiative, which also includes medical professionals and key stakeholders.

This is a platform for engagement. It provides opportunity for governments to work together on screening recommendations and approaches. For example, the national committee is currently looking at breast cancer mortality and improving screening for underserved populations. This committee encourages the sharing and pooling of information. This is a basis for a balanced set of protocols across Canada, based on best practices. There is no monopoly on a good idea, and an effective screening mechanism in one part of the country can easily be adopted in another part of Canada.

In addition to the Canadian breast cancer screening initiative, the government has also established a national repository on breast cancer screening. This national database is housed and administered by the Public Health Agency of Canada. Information is provided by provinces and territories and rolled up into a biannual report to Canadians on new cases of breast cancer and cancer deaths. The report also contains data on participation in organized screening programs, mammography use and follow-up.

In line with the bill, the database would include breast density information in the future. This is an important addition to the repository. In turn, information would be provided to Canadians on this important issue.

The Canadian breast cancer screening initiative would continue to provide a decision-making tool for women. It, too, would include information on breast density.

All this good work is helping build awareness and understanding of the effects of breast cancer screening on breast cancer survival rates and other important issues.

In sum, the Canadian breast cancer screening initiative is an invaluable collaborative effort. It accesses new information about screening on a regular basis; it ensures that programs and policies are informed by the most up-to-date information; and it provides good information to help Canadians and to help professionals make the best possible decisions about breast cancer screening.

The bill also recognizes the important work done by the Canadian Partnership Against Cancer on cancer prevention and control, more generally. Our government established the Canadian Partnership Against Cancer in 2006 to implement the Canadian strategy for cancer control. In March 2010, we renewed its funding, investing $250 million for another five years.

The Canadian Partnership Against Cancer is an independent, not-for-profit corporation. Its work includes prevention, early detection, treatment and support for Canadians living with cancer, and it involves many players, such as cancer experts, charitable organizations, government cancer agencies, national health organizations, patient survivors and others. Our investments in the Canadian Partnership Against Cancer help provide women with up-to-date information on breast cancer screening.

Recently, the bill was discussed at length in committee and a number of experts and witnesses shared their stories with us. I thought I would share a few.

Ms. Feather Janz detected a lump in her breast at age 20. However, despite going for numerous tests, cancer was not detected. She was finally diagnosed with highly aggressive grade three breast cancer at the age of 23. She underwent a radical surgery and her left breast was removed.

About 12 years later, Feather started to feel that her remaining breast was not quite right. Over the next four years, she continually went for mammograms but, again, nothing was detected.

The reports contained notations like “high dense breast tissue”, “too dense”, “quite dense” and “not able to see any abnormalities”. That is all the reports said. Feather insisted on surgery to have the other breast removed, and after the procedure the pathology report stated that it, indeed, had been a case of advanced aggressive breast cancer that had already spread to her lymph nodes. Feather told the committee she was shocked when she found out that the likely reason for this happening, and her life being threatened due to it, was because of dense breast tissue.

Another example is Mr. Bruce Cole, who testified before the committee about his wife, Sharon, who was diagnosed with breast cancer at age 36 and passed away at 40. Bruce Cole is from the same region of the country that I come from, Simcoe County. Mr. Cole talked about the incredible tragedy of losing his wife, who left behind children aged 17, 15 and 13. Her family had no history of this terrible disease and Mr. Cole testified that, regrettably, his wife did not have access to the screening technology and the knowledge we have today.

Since Sharon's tragic death, Bruce has been very active with the Canadian Breast Cancer Foundation as a donor and volunteer, and he attended the world forum on breast cancer last June in Hamilton. Bruce urged the committee to pass Bill C-314. He said it would help improve the quality of information to women as part of Canada's organized breast screening programs. Bruce knows this bill would help raise women's awareness about breast density and its implications for their health.

Bruce correctly pointed out to us that digital mammography or MRI are more effective than screen-film mammography at detecting breast cancer in dense breast tissue like his wife had, and he emphasized the need for sharing information between the Public Health Agency of Canada and the provincial and territorial governments. Sadly, Bruce understands that his wife might be here today if these practices had been in place when Sharon needed them most, but he bravely soldiers on, fighting this battle in her memory.

With all of us working together, we can improve screening and early detection and provide important information to women, health care professionals and Canadians. Bill C-314 calls on us to do exactly that. By passing this bill, we can ensure awareness is raised about breast cancer screening for women with dense breast tissue. We can ensure that existing initiatives assist women and health care professionals in making well-informed decisions regarding screening. Raising awareness about breast cancer screening can lead to early detection, and early detection can save lives.

For these reasons, I encourage all members of the House to support my bill, and I sincerely hope that it will go a long way in helping to save more lives in the future.

I know this is something Canadians care passionately about. Every October the breast cancer walk is held in communities across Canada. In my home town, Barrie, there is a sea of pink, people walking on the shores of Kempenfelt Bay to support breast cancer research. This is a way to support the collective will of Canadians who say they want us to act and make a tangible difference in fighting breast cancer.

Breast Density Awareness ActPrivate Members' Business

May 8th, 2012 / 5:45 p.m.
See context

NDP

Libby Davies NDP Vancouver East, BC

Mr. Speaker, I would like to congratulate the member for Barrie for bringing this bill back to the House. As he knows, New Democrats supported it in committee.

I am glad he read some of the testimony from the witnesses, because it was very compelling. I recall that one of the really important pieces of testimony committee members heard was about new technology that is available. We heard that even the existing technology, whether it is mammograms or MRIs, unfortunately, does not capture all situations that women with dense breast tissue are facing. I forget the name of the new technology the committee heard about, but there are only one or two locations in Canada.

I wonder if the member would agree with me that it is very important that we find a way to ensure that technology is made available and accessible and is not just a private for-pay service, because it really does affect women who have dense breast tissue. We heard that very directly from the one organization that has made it its mandate to warn women about this issue and encourage them to take the test, but they have to pay for it. I wonder if the member would comment on that.

Breast Density Awareness ActPrivate Members' Business

May 8th, 2012 / 5:45 p.m.
See context

Conservative

Patrick Brown Conservative Barrie, ON

Mr. Speaker, I thank my colleague from the health committee for the question, and the New Democrats for their support for this bill. It is much appreciated and an example of how we can work collaboratively in this House.

New technology is critically important to the health care system. That testimony was invaluable. There are technologies out there that can 100% detect breast cancer. If women have dense breasts, in many cases, mammography is not accurate, but we know that an ultrasound or an MRI can accurately show if there is breast cancer. However, we did hear testimony about technology beyond ultrasound or MRI. That is the exciting thing about health care. As much as the system is challenged in many ways, technological advancements are a great way to deal with these challenges. I am happy to see our health committee studying technology in health care, because it opens the door for advancements in health services.

This bill does not deal directly with new technology, but by sharing best practices, it opens the door for that conversation. Obviously, we cannot have verbal recommendations saying “Spend money on this” in a private member's bill. However, that collaborative approach with the provinces and that best practices format, if there is a technology that is utilized in Newfoundland, perhaps will allow the provinces to rapidly work together to have these new technologies adopted in every health care system.

That is one of the measures that the bill focuses on, that collaborative approach among the provinces, territories and the federal government to ensure the best possible health care delivery throughout Canada.

Breast Density Awareness ActPrivate Members' Business

May 8th, 2012 / 5:45 p.m.
See context

NDP

Libby Davies NDP Vancouver East, BC

Mr. Speaker, I am very pleased to rise in the House today to speak at report stage, the first hour of debate, to Bill C-314. I would like to congratulate the member for Barrie for bringing forward this bill. I agree that when we bring forward private members' business, whether it is a bill or a motion, it is an opportunity for each of us to show initiative, to bring forward an issue for greater awareness and, hopefully, get support in the House to make an advancement. There are women who live with dense breast tissue and may not be aware of their higher risk. There is still unfortunately too little known about the issue. So we very much appreciate this bill coming forward.

When we were at committee, we heard a number of fantastic witnesses. I agree with my colleague that the witnesses who shared their personal experience with us were very compelling. This tells us where things are and what it is that we need to do. I was struck by the witness who talked about innovation and new technologies. There is technology available that will assist women with dense breast tissue 100%. I am very concerned that even if women are aware of that, they may not be able to access the technology because of where they live. It may be very far to travel or they may not be able to afford the fees. It is a private service. It seems to run contrary to the fundamental principles of the Canada Health Act: universality, accessibility, public administration, comprehensiveness and so on.

I want to put on record here at report stage that the NDP supports the bill. However, after we heard from the witnesses, our concern in committee was that the bill was quite limited in its scope. It talks about information and information sharing, best practices and creating better awareness. All of those things are an absolute must, but they are sort of the bottom floor. For us in the NDP, when we heard the witnesses, we felt that we needed to go some extra distance with the bill.

We introduced a number of amendments. The most significant amendment said, “working in collaboration with provincial and territorial governments to establish national standards for systematic breast cancer screening”. Unfortunately, that amendment and all the other amendments were defeated. It was disheartening that all of the amendments put forward in good faith from the opposition parties at the committee were turned down. I do not think they were beyond the scope of the bill. While I concur that information and awareness are very important, we could be doing so much more.

We are now more aware of which women are at risk. I believe this bill will help get a message out, and that is very important. However, we in the NDP believe that there should be a nationwide systematic breast cancer screening program for all women. It should be free of charge and it should be by self-referral. It is quite alarming that, for example, there is no screening program in Nunavut. This seems to be a glaring omission and speaks strongly to the need for a nationwide systematic screening program with standards for screening.

We heard from practitioners at the committee that if a woman has gone beyond a mammogram and is going for an ultrasound, even that can be very problematic. It depends on how experienced the practitioner is doing the ultrasound. It is not about human error, but it is a very delicate procedure in terms of what one is looking for. It did surprise me to hear that even if a woman has an ultrasound, it may not identify the fact she is at risk or may have cancer present.

Similarly, we all think that MRIs are a real window into what is going on. However, we heard that for women with dense breast tissue, even an MRI may not pick up their particular situation. We heard from a witness about the newest technology that involves 360° imaging.

This speaks to a lack of available screening and a lack of national standards to ensure that wherever one is in the country, one can be assured of getting the highest quality screening and care. Under the Canada Health Act, that is very much a part of our health care system.

I do not want to be negative, but the bill is mostly about information and awareness. While it is important, I feel that we missed an opportunity to do a lot more with this bill. Although opportunities were put forward at the committee, unfortunately the government members decided not to vote for those amendments. Now here we are at report stage with a bill that is quite limited in its scope.

We will support the bill because it is a step to providing much better awareness about dense breast tissue. I was not aware of it before I heard about the bill. It is an eye opener for all of us. For that it is commendable.

However, I wish that we had been able to strengthen the bill in the way that we wanted, and that we could have responded to witnesses' suggestions to the committee. Maybe at some point there will be another bill and we will get another opportunity.

When we hear from people at committee we should do our utmost to respond to what they say. We should listen in good faith to their suggestions. Where it is possible for us to incorporate those recommendations in a way that is realistic within a private member's bill, then why on earth would we not do that?

That is my only regret. I certainly appreciate the member putting this bill forward and getting it this far. I am sure that the bill will be approved. Let us all make a commitment in this House today, not only to support this bill but also to advocate for a nationwide breast cancer screening program to ensure that women in Nunavut have access to even the most basic screening.

We need to address the issue of standards for screening to ensure that where there are these unique challenges of detecting cancer in women, particularly women with dense breast tissue, that they are getting the very best they can get so that their risk is lowered and not increased.

Breast Density Awareness ActPrivate Members' Business

May 8th, 2012 / 5:55 p.m.
See context

Liberal

Hedy Fry Liberal Vancouver Centre, BC

Mr. Speaker, I will speak, as I have done in the past, in support of the bill at report stage, but not with the same enthusiasm that I did earlier. As my hon. colleague for Vancouver East just mentioned, the bill went to committee, and it did not implement many of the changes that would have strengthened the bill and made it far more effective. I will speak to that a little later.

The bill's intent is to ensure that women and health care providers have the best information possible regarding screening, especially regarding new technology, and an understanding about dense breast tissue so that women know about it and health care providers and technologists understand what to look for. We know that tumours can be harder to identify in women with dense breast tissue. I would like to add, though, that it does not necessarily mean that a woman with dense breast tissue is more likely to have breast cancer. It is just that it is harder to identify if she does.

Twenty-three thousand women will be diagnosed with breast cancer in Canada this year. Sadly, nearly a quarter of those women will die from that disease, so in many ways this is an important bill, in that it speaks to the issue of identifying and finding a cancer as early as possible.

The federal government has a definitive role to play in facilitating best practices and funding research related to cancer prevention and early detection as part of the Canadian partnership against cancer, which is a federal initiative with the provinces, especially, as well, since the 2004 health accord strengthened the federal leadership role in ensuring access to health care services no matter where people live in Canada.

Where I find a problem, and I find it disappointing, is in relation to the health committee's recent study this bill. We heard from many witnesses. We heard from experts, health care professionals, patients and researchers. They all agreed that the intent of the bill is a very good one. They all agreed that awareness is important and that information sharing is important. However, they all felt that the bill would fall short of achieving any really important outcomes unless some pieces were added to it.

The member who moved the bill earlier on praised the co-operation and collaboration across parties on his bill. However, it stopped short in the House of Commons and at committee stage, where witnesses made some very compelling testimony. They talked about ways to improve the bill to improve its effectiveness. This was voted down, not only by the member for Barrie, who moved the bill, but also by members of the Conservative Party.

A couple of items that I moved as recommendations to strengthen the bill came from the witnesses. One of them is about sharing best practices. Subclause 2(c) of the bill talks about the ability of the Public Health Agency of Canada to look at information and data sharing, et cetera. I consulted so that it would not add cost at all. I heard from the legislative wing of the Library of Parliament that in fact there was a way to make sure this would incur no cost. It would use the already existing infrastructure of the Public Health Agency of Canada, where they have data and information sharing, to add best practices.

The reason for this, as we heard from witnesses, is that there are provinces, such as my province of British Columbia, where the outcomes of breast cancer are, by enormous percentage points, better than anywhere else in Canada. Therefore, why do we not take a page from their book? Why are we allowing people to continue to reinvent the wheel when we know what would work? Of course, as with anything to do with health, time is of the essence. Why wait six years for someone to discover a new wheel, when other people discovered it six years ago and we could be implementing it now for the benefit of patients?

Therefore, I was really very disappointed that the member himself did not accept that amendment. In fact, he said that his concern was with the word “ensuring”. He said that the work of the Canadian breast cancer screening initiative is not controlled by the Public Health Agency of Canada and that as such it should not be “ensuring” the collection, processing and distribution of information or “ensuring” the identifying, synthesizing and distribution of best practices. However, in subclause 2(c) he himself suggests sharing information through the Canadian breast cancer screening initiative.

It seemed as if this amendment, which would have enhanced the bill, was blocked purely because it was going to change the bill in some small way, even though to improve it.

Perhaps in his final remarks today, the member could clarify why such a no-cost, important thing that we heard from witnesses over and over was rejected.

I do not for one moment impugn the intentions of the member. He did a lot of hard work. I think it is an important bill and I think he brought forward a lot of things about it, but it had no teeth. There was nothing that would really change outcomes, other than increasing awareness.

This is an example of what concerns many of us, which is that the government is not listening to the expert testimony of witnesses appearing before committee, especially on bills and especially when these witnesses enhance the bill. It is a pattern.

I would like to say that we saw the same thing with Bill C-300. Witnesses appeared before the health committee and made several suggestions to establish a truly effective framework for suicide prevention. Twenty-one amendments were brought forward, including nine by the Liberal Party, and every single one of them, none of which incurred new costs, was voted down for no really logical reason that was given.

What we are left with are toothless bills that sound good and do small things, but do not really improve very much the lot of women with dense breast tissue or a suicide prevention strategy.

I hope this is not about ideology, because most of us have been supporting these bills because the intent is good. However, we would like to see them actually make a difference to the patients.

As I said before, I support the bill, but with a great deal of disappointment and reluctance.

Breast Density Awareness ActPrivate Members' Business

May 8th, 2012 / 6:05 p.m.
See context

St. Catharines Ontario

Conservative

Rick Dykstra ConservativeParliamentary Secretary to the Minister of Citizenship and Immigration

Mr. Speaker, I am certainly pleased to be speaking in support of Bill C-314, regarding dense breast tissue and the importance of breast cancer screening.

The bill was introduced by our colleague, the hon. member for Barrie. I would like to thank him for bringing it forward. When it comes to his health, this member is certainly putting his money where his mouth is. He is constantly ensuring that he is staying in the shape he needs to be in to be able to do his work.

In fact, as many of us know, the Toronto marathon was held over the weekend, and the member for Barrie competed, running a tremendous marathon and coming in one minute short of being able to qualify for the Boston marathon. Bringing this bill forward speaks highly of this member.

This bill puts a spotlight on an important issue. Breast cancer is the most common form of cancer among women in Canada. There are a number of risk factors associated with breast cancer, and dense breast tissue is a significant one.

Greater awareness of this risk is needed. Bill C-314 calls for exactly that, for expanding awareness of breast cancer screening for women with dense breast tissue. It is well established that early detection through breast screening can save lives.

By supporting this bill, we can make a difference in the lives of many Canadians. As noted in the bill, Canadian women will benefit from increased awareness of the challenges related to breast cancer screening for women with dense breast tissue. An important aspect of the bill is that it is dedicated to improving collaboration with partners to improve and share information on breast cancer screening with women and their doctors.

Bill C-314 will complement several current government actions supported by other partner organizations on cancer, breast cancer and breast cancer screening in our country. It is a priority for our government. Every single year, millions of Canadians are affected by cancer, either personally in terms of being subjected to the disease or by the experience of a family member or a friend or neighbour.

One in nine women in Canada will develop breast cancer during their lifetime. I am sure all of us who sit in the chamber today know a relative, friend or neighbour who has been affected and how stressful an experience it can actually be.

Early detection through organized screening programs is a key public health practice. It can protect women from breast cancer and the emotional, financial and personal costs that can often be associated with the disease.

Breast cancer screening can find cancer even when there may not be symptoms. The goal is to find breast cancer early, when it is small and less likely to have spread to other parts of the body. The most common method of breast cancer screening is a mammogram, which uses X-rays to take pictures of the internal structure of the breast.

For women with dense breast tissue it can be more difficult to detect small changes in the tissue that could be cancer, because both dense tissue and tumours appear as white space. This is why it is important for women in Canada and health professionals to be well informed so that they are able to discuss and make the best decisions around dense breast tissue screening.

Through better sharing of information and raised awareness of the risks presented by dense breast tissue, early detection through organized screening programs can help women in Canada by catching cancer at an early stage.

Our continued progress on cancer prevention and control relies on working across sectors, jurisdictions and organizations. The government has invested in partnerships that promote optimal screening, working with provinces and territories that deliver the services and with partner organizations.

Together we want to improve screening and early detection and to provide desperately needed information to women. That is exactly what Bill C-314 calls for: an assurance that we are doing all that we can with what we have to increase awareness and to assist health care providers and women in making well-informed screening decisions.

The bill's preamble recognizes that we are taking action related to screening through a number of initiatives. This bill reinforces our commitment and action on prevention, detection and control. It acknowledges the work this government does through the Canadian Partnership Against Cancer, the Canadian Institutes of Health Research and the Canadian breast cancer screening initiative. The knowledge and information generated through these initiatives is then shared with doctors and networks that include health organizations.

The central initiative supported by the government to fight cancer is the Canadian strategy for cancer control. It is a coordinated, comprehensive strategy that was developed with governments, non-governmental cancer organizations, cancer survivors, researchers and health care professionals.

The government created and provides funding to the Canadian Partnership Against Cancer to lead the implementation of the Canadian strategy for cancer control in collaboration with provincial and territorial governments and non-governmental organizations.

The Partnership Against Cancer is an independent, not for profit organization whose work is focused on prevention, early detection, treatment and support for Canadians who live with cancer.

Screening and early detection is one of the main priorities of the strategy. Breast density and its implications for cancer screening are part of this strategic priority.

The Partnership Against Cancer has done much to ensure that cancer patients and doctors across Canada have state of the art knowledge about what works to prevent, diagnose and treat cancer. It has encouraged hard to reach populations, such as newcomers to Canada, rural Canadians and people with disabilities, to undergo screening. This work has helped doctors to identify cancer at a much earlier time in an individual's life.

The government's cancer strategy is about people making a difference by working together and learning from each other so that Canadians, no matter where they live, can benefit.

One of the main resources offered by the federal government is the cancer view portal. This is a convenient single window for information for Canadians on cancer issues, including breast cancer screening. Cancer view connects Canadians to quality cancer resources. It provides tools to health professionals, patients and families, and it links people in the Canadian cancer community with each other.

To ensure that the valuable work of the partnership continues, the government has renewed its funding from 2012 to the 2017 fiscal year, providing up to $250 million over that period of time. It is not the amount that is important, it is what the funding enables the Partnership Against Cancer to continue to do, and that is to raise awareness and provide the tools that strengthen prevention. It is important work aimed at reducing the number of new cases of cancer, increasing the likelihood of Canadians surviving cancer and improving a patient's quality of life. Its activities cover a wide range of areas, from cancer control and prevention to palliative and end of life care.

The federal government also makes significant investments in research, surveillance and education, focused on preventing and reducing cancer.

The Canadian Institutes of Health Research is at the centre of the government's research efforts. It provides more effective diagnostics, better treatment and more efficient prevention strategies for all cancers, including breast cancer.

Research investments in this area are supporting Canadian scientists and they are helping to fill critical knowledge gaps in our understanding about breast cancer.

In addition to searching for a cure, Canadian medical researchers are also helping to reduce the burden of cancer on individuals and families by providing information to develop prevention strategies.

CIHR's Institute of Cancer Research is leading an international imaging initiative in personalized medicine and this initiative includes breast cancer as a focus. Such scientific research is helping to improve screening in health care settings and contributes to building understanding about early diagnosis, as well as access to better quality cancer care.

Bill C-314also highlights the importance of providing women and their doctors with the information they need to make decisions that affect and impact their health. The government is taking steps to increase awareness, to fund research and to provide information to Canadians about cancer prevention and early detection.

In addition to the good work already mentioned, the federal government is promoting education and makes information and resources available to communities across our country through the Canadian breast cancer initiative.

The community capacity building program is a key component of the Canadian breast cancer initiative. The community capacity building program supports organizations and provinces and territories to network with provincial and community breast cancer groups. This cross-Canada collaboration enables the sharing of best practices and ensures that information and supports are available for women with breast cancer.

Together, they regularly assess new information about screening to improve programs and to ensure that women have the full benefit of early detection. By raising awareness around breast density, we are also encouraging this important practice. It is essential to have the right information about dense breast tissue in order to determine the best screening method.

The government is engaged in cancer prevention research and education. We are raising awareness about the many health issues faced by Canadians. Clearly, we all have a role to play in the fight against breast cancer.

The member for Barrie understands, as does this House and this government, that this bill ensures the federal government will continue to raise awareness through existing initiatives about the challenges related to breast cancer screening for women with dense breast tissue.

Bill C-314 is another step forward for Canada in tackling breast cancer. I ask all members of the House to support this very important bill.

Breast Density Awareness ActPrivate Members' Business

May 8th, 2012 / 6:15 p.m.
See context

Conservative

Patrick Brown Conservative Barrie, ON

Mr. Speaker, I am thankful for all of the comments so far in the House on this debate. I thank the member for St. Catharines for his eloquent comments on this. It is great to have such a hard-working colleague, like the member for St. Catharines, support this bill.

There were some concerns raised by the member for Vancouver Centre from the Liberal Party. I realize that her submission was that there should be language that said “a best clearing house”. I just want to explain that, as much as we appreciated her amendment and suggestions, we felt that the language was already in the bill.

However, I am heartened that members of the official opposition have supported this bill throughout the process and that the member for St. Paul's, who initially spoke to the bill on behalf of the Liberal Party, did so enthusiastically. I think these are the types of issues we can rally behind. There was no intention to ignore the amendment from the member for Vancouver Centre. It is just that the language was already there. I am a big believer that it is important that we not be redundant in terms of having multiple paragraphs in a bill that stipulate and say the exact same thing.

I believe we have a bill that works in the best interests of breast cancer patients. The reason I selected this as a topic to push here in the House of Commons is because where I come from in Barrie, for the entire time that I have been involved in elected politics, and I was elected to city council in 2000, the number one issue in Barrie was building our cancer centre. it will finally open on May 17 but it has been an 11-year fundraising campaign and something that I know is incredibly important to Simcoe county. When I asked members of the community what type of bill I should work on, the resounding response was something cancer related. This is something that our community has really rallied behind.

Members of the medical community and friends here in Ottawa who worked within Health Canada gave me suggestions but this was a suggestion we thought we could tangibly make progress on and tangibly move forward. I really believe this is an issue that is not partisan at all. It is an issue that every party can get behind and support because when it comes to trying to increase the survival percentages of breast cancer patients, it is something that is important to every community in Canada.

There has been tremendous progress in Canada. Having survival rates of 80% is an accomplishment for Canada but I believe we can go even beyond that. Embracing new technology, raising awareness and ensuring that we have best practices across Canada for dense breast tissue will enable us to reach new levels of success in beating breast cancer.

I appreciate the support of my colleagues in the House and I hope it will pass in this House very shortly.

Speaker's RulingBreast Density Awareness ActPrivate Members' Business

March 12th, 2012 / 7:05 a.m.
See context

Conservative

The Speaker Conservative Andrew Scheer

There is one motion in amendment standing on the notice paper for the report stage of Bill C-314, standing in the name of the hon. member for Vancouver Centre. At first glance, it appears that this motion could have been presented in committee.

However, in submitting her motion for consideration at report stage, the member for Vancouver Centre provided the Chair with a written explanation in which she outlined her efforts to propose a similar amendment during the clause-by-clause study of the bill, and where she explained that her amendment was based on the testimony of witnesses who had appeared earlier in the meeting. As the committee desired to proceed with the clause-by-clause study of the bill immediately after hearing from the bill's sponsor and other witnesses, she did not have time to avail herself of the drafting services of the parliamentary counsel assigned to the bill.

Upon presentation of her amendment, the member was cautioned by the chair of the committee that there was some concern over certain legal terminology her amendment contained that might have had the undesired effect of infringing on the financial initiative of the Crown. In this case, there was not sufficient time for the chair of the committee to carry out the necessary consultations and provide a definitive ruling on admissibility. As a potential remedy to this unusual situation, the chair of the committee suggested to the member that she might wish to submit her amendment at the report stage instead.

Having received the committee's consent to withdraw the amendment, the member for Vancouver Centre explained that she was able to consult with parliamentary counsel and the legislative clerk assigned to the bill. She was thus able to prepare a motion for the report stage which she feels, and I agree, does not appear to infringe on the financial initiative of the Crown. Therefore, due to the exceptional circumstances outlined above, the Chair has selected for debate the motion submitted by the member for Vancouver Centre.

I shall now propose Motion No. 1 to the House.

Motions in amendmentBreast Density Awareness ActPrivate Members' Business

March 12th, 2012 / 7:05 a.m.
See context

Liberal

Hedy Fry Liberal Vancouver Centre, BC

moved:

Motion No. 1

That Bill C-314, in Clause 2, be amended by adding after line 20 on page 3 the following:

“(d) ensuring, through the Canadian Breast Cancer Screening Initiative, the collection, processing and distribution of information on best practices for the screening and detection of cancer in persons with dense breast tissue.”

Mr. Speaker, this is a very simple amendment. It says that there is already a Canadian breast cancer screening initiative. This vehicle, without any extra cost or work whatsoever, can conduct the collection, processing and distribution of information on best practices for the screening and detection of cancer in persons with dense breast tissue.

This is necessary because we listened to many witnesses who said that there are some places where this is being done well in Canada. There are other places that are doing some fairly remarkable innovative work in collecting this information. Witnesses felt it would be quick, easy and very valuable if other provinces and areas could use some of those best practices. Those provinces and areas would not have to reinvent the wheel because in many practices currently there is excellent work being done. It has been done for long enough now that there is evaluation that says this works very well.

There have been suggestions from the Canadian Cancer Society and cancer associations that in places like British Columbia the outcomes from breast cancer screening, treatment and surgery are by far the best in the country, by a really large percentage. We need to look at some of the areas which are doing good work, borrow it and use it without having to spend a lot of time reinventing the wheel, as I said before. This would be very beneficial.

This is an excellent amendment that would really enhance the bill to a great extent.

Motions in amendmentBreast Density Awareness ActPrivate Members' Business

March 12th, 2012 / 7:05 a.m.
See context

Conservative

Patrick Brown Conservative Barrie, ON

Mr. Speaker, Bill C-314, An Act respecting the awareness of screening among women with dense breast tissue, is a piece of legislation that I have drafted because I truly want to make a difference. I want to ensure more women are aware of the impact of dense breast tissue on the analysis of a mammogram.

The bill would encourage the use of existing initiatives to increase awareness among women about the implication of dense breast tissue for breast cancer screening, and to assist women and their health care providers in making well-informed decisions regarding screening. It would recognize the work done by the provinces and territories and by many organizations in working towards these important goals. It outlines partnerships that our government has developed to enhance understanding of and to disseminate information about dense breast tissue during screening. I want to thank members from all parties for their support of this bill. I know full well that we are all anxious to ensure the bill passes as quickly as possible.

I would like to thank the hon. member for Vancouver Centre for her support and interest in this bill. She has expressed a desire to ensure best practices are disseminated. She has pointed out that Bill C-314 refers to sharing, through the Canadian breast cancer screening initiative, information related to the identification of dense breast tissue during screening and any follow-up procedures.

Indeed, the Canadian breast cancer screening initiative already helps us look at the best ways to raise awareness of dense breast tissue. The initiative also helps provide screening performance information and support evidence-based decisions.

Launched in the early 1990s, the initiative fully respects the role that provincial and territorial programs play in the early detection of breast cancer in Canadian women and the importance of sharing information and exemplary practices. In fact, it enables provinces and territories to continually share information on their screening programs, and discuss what they are learning.

To ensure strong collaboration and to work in a collective fashion to assess breast cancer screening programs, the government established the federal, provincial and territorial national committee for the Canadian breast cancer screening initiative. The committee is instrumental in providing us with the opportunity to work with provincial and territorial governments to measure screening program performance throughout the country and to develop better screening approaches.

This committee also includes non-governmental organizations, medical professionals and stakeholders. This allows for more opportunities for dissemination of practices, as well as for sharing different views. The initiative is aimed at evaluating and improving the quality of organized breast cancer screening programs. By facilitating information sharing about breast cancer screening across Canada through governments, practitioners and stakeholders, it can achieve this goal.

The bill clearly outlines the need for the Government of Canada to “encourage the use of existing programs and other initiatives that are currently supported by” the entities that have a role in breast cancer screening, be it prevention, detection, treatment, monitoring, research or the provision of information. Collaboration amongst these entities is instrumental.

Members will note that there is a great deal of good work under way through the Canadian breast cancer screening initiative. Jurisdictions are working together, sharing best practices and discussing questions that are important to them.

The amendment brought forward by the hon. member is consistent with the goals and approach of the initiative. The national committee has well-established partnerships to undertake identification and distribution of information on best practices. The committee can direct analysis on breast cancer screening, including best practices for dense breast tissue.

The dissemination of information and facilitation of use of best practices in screening in assessment are key objectives of the initiative. Provinces and territories can use this information for their respective breast cancer screening programs. The proposed amendment speaks to the need for collecting and processing information on best practices for breast cancer screening, and more specifically dense breast tissue. This is a fundamental part of the initiative. It is already enabling us, along with our provincial and territorial colleagues, to look at the best ways to raise awareness of dense breast tissue.

The Public Health Agency of Canada, through the Canadian breast cancer screening database, collects, synthesizes and distributes information on the breast density of women who are screened. It provides this information to provincial and territorial breast screening programs to support the development of best practices.

The concerns with the amendment are with regard to the word “ensuring” used in the proposed amendment. The work of the Canadian breast cancer screening initiative is not controlled by the Public Health Agency of Canada, and as such should not be ensuring the collection, processing and distribution of information or ensuring the identifying, synthesizing and distributing of information.

Therefore, while l appreciate the intention of the hon. member for Vancouver Centre, I do not see the need for this amendment. As we all want to get the bill through, I ask my fellow colleagues to continue to show support for the passage of the bill. Greater awareness and information about dense breast tissue will enable us to make a difference. It would help women and their doctors make well-informed decisions regarding breast cancer screening.

Again, I want to thank the member for Vancouver Centre for bringing this issue up. I hope all my fellow colleagues can continue to support the bill.

Motions in amendmentBreast Density Awareness ActPrivate Members' Business

March 12th, 2012 / 7:10 a.m.
See context

NDP

Rosane Doré Lefebvre NDP Alfred-Pellan, QC

Mr. Speaker, I am very pleased to rise in the House today to debate Bill C-314, An Act respecting the awareness of screening among women with dense breast tissue. As a young woman, I am aware that I am at risk of developing breast cancer. In fact, we all are, because breast cancer can affect anyone, both men and women, young and old.

According to the statistics, 23,400 Canadian women and 190 Canadian men were diagnosed with breast cancer in 2011. Age is an important factor. It is a fact that older women are at greater risk. In 2011, an estimated 80% of cases were diagnosed in women over the age of 50. Young women are also at risk. It is estimated that 3,500 new cases, or 14%, were reported in women between the ages of 30 and 49 years, and 965 cases, or 4% of cases diagnosed, were women 40 and under.

According to the Canadian Cancer Society, breast cancer starts in the cells of the breast. The breast tissue covers an area larger than just the breast. It extends up to the collarbone and from the armpit across to the breastbone in the centre of the chest. Each breast is made of mammary glands, milk ducts and fatty tissue. The breasts also contain lymph vessels and lymph nodes, which are part of the lymphatic system. The lymphatic system helps fight infections. Lymph vessels move lymph fluid to the lymph nodes. Lymph nodes trap bacteria, cancer cells and other harmful substances. There are groups of lymph nodes near the breast under the arm, near the collarbone and in the chest behind the breastbone. Cancer cells may start within the ducts or in the lobules. Ductal carcinoma is the most common type of breast cancer.

As a woman, I know the importance of mammography, which is a low-dose x-ray of the breast. Mammography pictures, or mammograms, show detailed images and views of the breast from different angles. The breast is placed between two plastic plates. The plates are then pressed together to flatten the breast. Compressing the breast tissue helps make the images clearer. Better quality mammography and increased participation in organized breast screening programs have led to more breast cancers being detected earlier, which means successful treatment is more likely. Unfortunately, this test does not always detect cancer, especially among women with dense breast tissue. In such cases, doctors may opt for scintimammography or an MRI. A biopsy is the only way to make a definitive diagnosis of cancer.

Breast density is a radiological concept, but it has a major impact on the accuracy of mammogram interpretation. Dense breast tissue is a concern for all radiologists, as well as epidemiologists and gynecologists. A dense breast appears white on a mammogram because it contains little fat.

Breast tissue is quite variable. Changes in breast tissue are hormone driven and occur throughout an individual's lifetime. For example, young women typically have denser breasts than older women because breast tissue becomes less dense as women age. However, even though older women's breasts tend to contain more fat, women of any age can have dense breast tissue.

Bill C-314 requires the Government of Canada to encourage the use of existing initiatives to increase awareness among women about the implications of heterogeneous or dense breast tissue for breast cancer screening, and to assist women and health care providers in making well-informed decisions regarding screening.

Although the purpose of this bill is to improve breast cancer screening for women with dense breast tissue, we believe that it should go further still. Why not institute accountability measures to shorten waiting lists and ensure that women have access to timely screening?

Any bill designed to improve breast cancer screening should include federal funding for national breast cancer screening programs for all women, which should be systematic, free and available without a doctor's referral, beginning at age 40.

Health care workers and women who are concerned about breast cancer need more than just encouragement in order to raise awareness and promote best practices.

The government should put in place standards. Under these standards, all provincial programs would start screening women for breast cancer from age 40. The standards should include the regular and optimal use of digital mammography machines such as MRIs and ultrasounds for screening purposes. Lastly, screening standards should focus on the particular challenges of screening for breast cancer among women with dense or heterogeneous breast tissue.

The Quebec breast cancer screening program is a good example of a screening program with very good results. Screening using a mammogram targets women aged 50 to 69 and is carried out, systematically, every two years. According to data from Quebec's health and social services department, the breast cancer mortality rate for women who are systematically screened dropped by at least 25% between 1996 and 2006.

It is high time that the federal government showed leadership by adopting a funding plan and implementing a real national strategy to improve breast cancer screening in Canada. That also means honouring the commitments made as part of the 2003 and 2004 health accords, including the commitment to reduce waiting times and increase the number of doctors and nurses to ensure that women at risk have access to primary care or specialists as quickly as possible.

Experts and organizations fighting breast cancer are asking for more and agree that this project does not go far enough.

The Canadian Breast Cancer Network does not believe that this bill will improve screening procedures for those women most at risk of developing breast cancer. Breast cancer survivors direct the network. It is a national link between all the groups and individuals concerned about breast cancer, and its members, partners and founders include the Canadian Cancer Society, the Canadian Breast Cancer Foundation and the Breast Cancer Society of Canada.

The Canadian Cancer Society supports a bill that would improve cancer screening measures, particularly for patients with dense breast tissue. However, the society believes that this bill will not produce concrete results for patients living with breast cancer and their families.

Lastly, Quebec's association of hematologists and oncologists says that while it is important to increase breast cancer screening, we cannot forget about other kinds of cancers. Improvements need to be made in the prevention of and screening for all cancers. We must not concentrate all our efforts on one single category of women or type of cancer.

I wonder when this government will start to take this issue really seriously? The Conservative government introduced a bill that will in no way improve the lives of Canadian women. The government must start thinking more seriously about this issue in order to prevent even more women from developing this destructive disease.

Motions in amendmentBreast Density Awareness ActPrivate Members' Business

March 12th, 2012 / 7:20 a.m.
See context

NDP

Christine Moore NDP Abitibi—Témiscamingue, QC

Mr. Speaker, Bill C-314 seeks to improve breast cancer screening measures for women with dense breast tissue.

One woman in nine is expected to develop breast cancer during her lifetime, and one in 29 will die of it. The current mortality rate is 21%. Risk factors can be both genetic and environmental, and breast tissue density is one of those factors, hence this bill.

Women with high breast tissue density face two challenges: the probability of developing breast cancer is higher and screening is more difficult because the X-rays are harder to read. It is therefore important to improve care for women with dense breast tissue because of the increased risks to their health.

This bill seeks to do that and:

...requires the Government of Canada to encourage the use of existing initiatives in order to increase awareness among women about the implications of heterogeneous or dense breast tissue for breast cancer screening, and to assist women and health care providers in making well-informed decisions regarding screening.

Still today in Canada, not all women are fully informed about breast cancer. As a former nurse, I know that not all women—far from it—have access to a family doctor and therefore to the chance to discuss the risks with a professional. Sometimes people in remote areas do not have the same access to health care as others. Sometimes women end up not having access to full and accurate information about breast cancer, its risks and the importance of screening. And the doctor ends up not having access to the patient's complete medical file because she has several different files. These women see a doctor when they go to emergency. In the long term, there is no continuity of care because doctor visits are always one-offs.

Women may be seen by their family doctor, and now by specialized nurse practitioners who may also work in this area. Nurse practitioners will ask questions, analyze risk factors, conduct assessments, teach women to perform breast self exams and help them do so. These concrete measures can help these women. If a woman does not have access to a family doctor or nurse practitioner, she will not know that she may have access to screening programs and, consequently, will not take advantage of them.

I believe that it is important to talk about this. Breast cancer will result in the death of 14 women a day in Canada in 2012. It is a very important issue. Screening and awareness of the risk factors are also major issues. Early diagnosis and treatment greatly increase women's chances of survival.

Women with dense breast tissue should be made aware of it and should undergo more tests before being given a diagnosis because cancer is more difficult to detect in x-rays of dense breast tissue. The more tests, the great the difficulty. Consequently it is important to promote detection screening to these women. It is also important to promote and to circulate this information among health professionals so that they can screen women.

We often see people die from cancer because of this. We must not take it lightly.

The Canadian Cancer Society's website talks about the determinants of survival. It points out the factors related to the cancer control infrastructure, such as the availability and quality of early detection, diagnosis and treatment.

Depending on where a woman lives and the quality of infrastructure available, and depending on the timeliness of detection, she will have a greater or lesser chance of dying of cancer.

This is not an equitable situation. In my opinion, access to health infrastructure should not be one of the determinants of breast cancer survival.

The fact that such is the case in Canada in 2012 does not make any sense. And this should also not be the case for any other illness. For example, to date, Nunavut does not have a formal screening program.

We therefore really need to do more than encourage the government to get the message out and to facilitate screening. Clearly, we need more concrete action. We need better access to health care and infrastructure; we need more family doctors, more nurses and more nurse practitioners; and we need improved prevention measures. We must decrease wait times—which have reached record highs—for tests and treatments. We must improve access to medical specialists who are better able to diagnose and treat these patients. We must work with the provinces to come up with a national strategy to combat breast cancer that is fair to all women, regardless of their geographic area or their income.

We have no choice. We must really discuss this with the provinces. We need real leadership on this issue. For example, Canada should abide by the 2003 and 2004 health accords, which were meant to improve the accessibility, the quality and the viability of the public health care system.

In order to prevent all these bills on health from being just words written completely in vain that look good on paper but do not contain any concrete measures, we should ensure that they include measures such as federal funding to create systematic breast cancer screening programs for all women across the country. These programs should be made available free of charge, on a voluntary basis, to women aged 40 and over. Right now, the systematic program that exists in Quebec is free for women over the age of 50.

I would like to take a few minutes to talk to you about my cousin Linda, who passed away from breast cancer when I was in Vancouver in June. Her daughter had just had her first baby when Linda learned that she had breast cancer. She was only 42 years old when she died. I believe that this is a concrete example of why systematic screening programs should be made available free of charge to women as early as age 40, not age 50. This is a good example, and I thought it was important to talk about what happened to my cousin. I was close to her, and 42 is very young. I thought it was important for members to be aware of this.

Such bills should also include standards requiring that existing provincial programs begin screening women at age 40. Early detection is essential and should be a priority. We know that. I do not know if people understand this, but the earlier in a person's life breast cancer—or any type of cancer—shows up, the more likely it is to be aggressive, because an immune reaction takes place. The stronger the immune system's reaction, the more aggressive the cancer can be. That is why very early detection is important, as I just explained.

Similarly, any health-related bills should include standards for existing screening programs to optimize and standardize the use of digital mammography equipment such as magnetic resonance imaging and ultrasound units. Women should have access to these devices, which, once again, improve detection rates, particularly for women with risk factors such as high breast density.

Health-related bills like this one must go farther: instead of offering vague suggestions, they have to propose practical measures. This must be done together with the provinces and territories, of course, because health is under provincial jurisdiction. It is important to truly work with the provinces to develop an action plan. If we do that, we can hope to save lives. If health-related bills are too vague, they are not useful; they are nothing but nice ideas on paper that do not really change anything for the better.

Breast Density Awareness ActPrivate Members' Business

December 9th, 2011 / 1:15 p.m.
See context

Simcoe—Grey Ontario

Conservative

Kellie Leitch ConservativeParliamentary Secretary to the Minister of Human Resources and Skills Development and to the Minister of Labour

Madam Speaker, I am pleased to speak in support of Bill C-314 regarding dense breast tissue and the importance of breast cancer screening.

Bill C-314 calls on the federal government to use existing programs and initiatives to increase awareness about dense breast tissue and its impact on breast cancer screening. The bill's focus is on working with partnerships to improve information and share information on screening with women and their doctors. Several current government actions are highlighted. They are supported by other partner organizations focused on cancer, breast cancer and breast cancer screening. I will explain more about these actions in my remarks today, but I would like to begin with a few words about how critical the underlying issue is.

Every year, millions of Canadians are affected by cancer either personally or by the experience of a family member, friend or neighbour. I have personally been affected by this disease with the loss of my mother in 1989. Because of this and my role as a surgeon, I know about the importance of breast cancer screening and awareness. Breast health, regular checkups and exams should be a conversation in every home in Canada. It is one that occurred in my family home. As one can imagine, it is not an easy conversation for a single father who has recently lost his wife to have with his young children. However, it is extremely important that parents have this conversation with all of their daughters.

Awareness starts at home, as well as in a doctor's office. Young women across the country should be in constant dialogue with family physicians when it comes to their breast health and determining what practices for screening are best for them. Breast cancer in particular is a major health concern. One in nine women in Canada develops breast cancer during her lifetime, making it one of the most common cancers affecting Canadian women.

In 2011, it is estimated that 23,400 women in Canada will be diagnosed with breast cancer, an increase from 2010. That represents about 450 women being diagnosed each week. Early detection of breast cancer through organized screening programs is an important public health practice. Our government has invested in partnerships that promote optimal screening. Our government works across different health sectors with partner organizations, as well as with provinces and territories that deliver health care services.

Together we want to improve screening and early detection and to provide information to women. That is exactly what Bill C-314 calls for: an assurance that we are doing all we can to increase awareness and to assist health care providers and women in making well-informed screening decisions.

This bill recognizes that we are taking action on this issue through a number of initiatives. We are reinforcing existing investments, commitments and action on prevention, detection and control. The bill also recognizes the important work done by the Canadian Partnership Against Cancer. This initiative was established and funded by our government. The bill highlights the work our government does through the Canadian Institutes of Health Research and the Canadian breast cancer screening initiative. The knowledge generated through these initiatives is then shared with doctors and networks that include health organizations like the Canadian Cancer Society.

The central initiative supported by our government to fight cancer is the Canadian strategy for cancer control. This is a co-ordinated comprehensive strategy developed with government, non-governmental cancer organizations, cancer survivors, researchers and health care professionals. Screening and early detection is the main priority of the strategy. Breast density and its implications for screening is a part of this.

The Canadian strategy for cancer control is implemented by the Canadian Partnership Against Cancer. The partnership is an independent not-for-profit organization that is working on prevention, early detection, treatment and the support for Canadians living with cancer. This organization has done much to ensure cancer patients and health care professionals across Canada have state-of-the-art knowledge about what works to prevent, diagnose and treat cancer.

Notably, the partnership has encouraged hard-to-reach populations to undergo screening, helping doctors to identify cancer earlier. Funding of $250 million to the partnership was recently renewed for five more years, from 2012 to 2017. This funding will help the partnership continue its invaluable work on reducing cancer cases, enhancing the quality of life of cancer patients and increasing the likelihood of survival.

Through CIHR, the government is funding research on more effective diagnostics, treatment and prevention for all cancers, including breast cancer. Research investments in this area support important Canadian scientific work. I want to stress that the search for a cure is only part of the incredible research being undertaken in this country. Research is helping to reduce the burden of cancer on individuals and families through informing the development of prevention strategies.

As well, scientific research is helping to improve screening in health care settings. It is contributing to early diagnosis and, in many cases, allows access to better quality cancer care. This year alone $22.7 million was spent on breast cancer research.

Bill C-314 highlights the importance of providing women and their doctors with the most recent information. Our government's Canadian breast cancer initiative contributes by making education and information resources available to communities across Canada. This work facilitates action on breast cancer, women's health, inter-sectoral collaborations, and stakeholder involvement.

The government supports the Canadian Breast Cancer Foundation's screening initiative, a key component of the Canadian breast cancer initiative. The screening initiative is a joint provincial-territorial collaboration to develop screening approaches. It contributes to improving breast cancer screening programs by developing nationally agreed upon quality indicators.

For women with higher breast density, breast cancer is generally harder to detect using mammograms, resulting in more frequent screenings. The Canadian breast cancer screening initiative supports national standards for prevention, early detection and screening. It seeks to develop and share best practices in breast cancer and women's health. Our government recognizes the importance of participating in cancer screening. Raising awareness around breast density supports this goal.

Through the screening initiative, we are working with the provinces and territories as well as local and non-governmental organizations to increase early detection and screening for populations less likely to be screened, such as newcomers to Canada, rural Canadians and persons with disabilities. This cross-Canada project enables the sharing of best practices, and ensures that information and support programs are available to women with breast cancer.

Through the Canadian breast cancer screening initiative and the Canadian partnership against cancer, our government helps the provinces and territories benchmark performance against national standards. It is equally important to share knowledge through health organizations such as the Canadian Cancer Society. The bill reinforces the current actions on breast cancer screening that reflects the government's commitment to keep Canadians and their families healthy, to help doctors detect cancer, and to give women better information on which basis to make their decisions.

I want to commend the hon. member for Barrie for his initiative which will not only better the information women receive regarding their breast health but will also lead to earlier detection and to more women's lives being saved.

I came face to face with the ramifications of breast cancer when I lost my mother 22 years ago. Compounded by my role as a physician, it is why I am so passionate on this issue. I strongly urge every member of the House to support this bill on the awareness of breast cancer screening, so that we can stand unanimous in this chamber in support of women's breast health.

I once again commend the member for Barrie for his excellent work on this bill.

Breast Density Awareness ActPrivate Members' Business

December 9th, 2011 / 1:25 p.m.
See context

Liberal

Carolyn Bennett Liberal St. Paul's, ON

Mr. Speaker, I am very pleased to rise here this afternoon to speak to Bill C-314. This bill calls on the Government of Canada to encourage the use of existing initiatives in order to increase awareness among women about the implications of heterogeneous or dense breast tissue for breast cancer screening, and to assist women and health care providers in making well-informed decisions regarding screening.

On behalf of our health critic, the hon. member for Vancouver Centre, I would like to say that the Liberal Party supports this bill. All efforts to raise awareness, to provide more information and to encourage communication must be supported.

As a family doctor, it became very clear to me and also in our work at the Women's College Hospital in Toronto that the world changed when books like Our Bodies Ourselves came onto the market, and women were empowered to know more about the choices in order to ask better questions of their doctors and demand better care.

The bill, which will respect the awareness of screening among women with dense breast tissue, is just that kind of initiative. So we as Liberals support any effort to increase awareness, to fund research, and to provide information to Canadians about cancer prevention and early detection. We know that we should be doing more of this in many areas of health, including health promotion, wait times and pharmaceutical strategies.

The proposed legislation calls on the federal government to work with the provincial and territorial governments to increase awareness among women about the risk factor involved in having dense breast tissue. It asks that we use existing programs. It asks that we identify the gaps in information for women and that we improve that information that is going to Canadian women. It asks that we address the challenges in detecting breast cancer in women with dense breast tissue.

This year, 23,400 Canadian women will be diagnosed with breast cancer and 5,100 will die. As the Parliamentary Secretary to the Minister of Labour has said, all of us are touched by breast cancer in some way. My mother died of breast cancer as well. She had two different breast cancers that took her life even in what was to be a lesser kind of breast cancer: breast cancer after menopause. My sister has had breast cancer diagnosed before menopause.

As a physician, I recognize the importance of early detection and ensuring that patients have the best possible information and treatment. Any oncologist would say very clearly he or she would rather find these cancers early when indeed they can be treated. The problem is the dense breast tissue makes it difficult to identify breast cancer. There are too many stories of what was presumed to be a negative mammogram that was later on shown to have a cancer hiding in the breast tissue that was not visible to the radiologist at the time.

We are blessed now in Canada that almost 80% of mammography is done with the new digital approach which makes it much easier to detect the problems in dense breast tissue, but still we need to do more. We need to require more tests and appropriate screening. It means that we need to ensure that people reading the mammography are experienced radiologists. Now with technology, help is possible for very experienced people with tremendous expertise in mammography can read them at a distance. The new machine in Moose Factory allows the people a long way away to be the actual expert reading the exams.

We always have to balance appropriate testing without alarming the general population or Canadians with unnecessary tests that only put more pressure on the system. We believe that the federal government does have a role to play in facilitating best practices and funding research related to cancer prevention and early detection as part of the Canadian partnership against cancer.

It is interesting that the California state legislature recently passed bill SB 173 that would require mammogram providers to inform women if they have dense breast tissue and that they would benefit from more screening. But is also interesting that the California governor, Jerry Brown, vetoed the bill noting that while it was important, the bill should have used more careful language so as not to create unnecessary anxiety among women and strain the health system. This message was echoed by the California Medical Association because of its risk of leading to unnecessary MRIs and ultrasounds.

We are pleased to see that Bill C-314 calls for research, information sharing, and increased awareness for women about the problems related to screening for those with dense breast tissue, which makes it hard to identify these tumours.

For any Canadian who wants to look at the movement in the United States, it is at rudense.com. There is very interesting information. It asserts that breast density is one of the strongest predictors of the failure of mammography screening to detect cancer. There is a very interesting logo, “Are you dense? exposing the best-kept secret”. Unfortunately the best-kept secret can take people's lives.

There are things that are coming forward: ways that we could detect the breast density on a scale of 1 to 4; letting women know which category they are in; what women should expect for themselves and their families in terms of the amount of screening; and the serious conversation women need to have with their doctors.

We in the Liberal Party are very keen on the idea of national clinical practice guidelines that every Canadian can come to know and understand. Therefore, regardless of their postal code, women could be asking for the best possible care based on the evidence-based clinical practice guidelines.

It means that family doctors are brought up to speed and can actually have meaningful conversations with their patients, not only about the clinical practice guideline but whether their individual situation places them in that average clinical guideline, or whether their situation is particularly special, such that a different plan of action or care plan should be there for them.

I am very pleased and thank the member for bringing the bill forward. We look forward to further debate.

As our party's health critic, I look forward to studying the bill with the hon. member at the health committee.

Breast Density Awareness ActPrivate Members' Business

December 9th, 2011 / 1:35 p.m.
See context

Conservative

Kelly Block Conservative Saskatoon—Rosetown—Biggar, SK

Madam Speaker, I am pleased to speak in support of Bill C-314, An Act respecting the awareness of screening among women with dense breast tissue, introduced by my colleague, the hon. member for Barrie.

The bill encourages the federal government to use existing initiatives to increase women's awareness of how dense breast tissue impacts breast cancer screening. We know that breast cancer is far too common in Canada. This year, some 23,000 Canadian women will be diagnosed with breast cancer, a one in nine chance over a lifetime, and breast cancer will claim the lives of 5,100 women this year alone.

We know that breast cancer screening saves lives. We also know that women with denser breast tissue face added challenges with cancer detection through mammography. Targeting dense tissue, as the hon. member for Barrie attests, is one tangible way we can make a difference. We can play an effective role in the adoption of effective, efficient early detection practices in screening. That is why we are raising awareness and providing accurate information about screening. This helps women make better decisions, particularly if they have dense breast tissue.

Bill C-314 focuses on the efforts already under way to raise women's awareness about dense breast tissue and breast cancer screening. It also would help women and their doctors make well-informed decisions regarding their screening.

There are a number of elements in the bill that I will outline, along with current federal initiatives that support this bill. First, the bill requires our government to determine if there are breast density information gaps in relation to breast cancer screening. By knowing where these gaps are, we can plug the holes through research. In response to the first element, our government will continue supporting cancer research through the Canadian Institutes of Health Research, or CIHR. A priority of CIHR's Institute of Cancer Research is early cancer detection. It is currently exploring partnership opportunities with the Canadian Breast Cancer Foundation for early detection funding. This research will address breast cancer information gaps.

Second, the bill would require that approaches be identified as needed to improve information for women. This would be done to address the challenges of detecting cancer in women with denser tissue and to raise awareness concerning these challenges. Bill C-314 also recognizes the responsibility provinces and territories have for delivering these invaluable programs. For example, when mammography identifies dense breast tissue, these programs notify women to obtain further testing. In Ontario, Nova Scotia, Newfoundland and Labrador and the Northwest Territories an annual recall system is in place for women identified with dense breast tissue. In other jurisdictions, follow-up is determined by the radiologist.

While breast screening programs are primarily a provincial and territorial responsibility, the federal government, through existing initiatives and partnerships, supports raising awareness of breast cancer screening and breast density. In response to this bill, the government will d continue to support provinces and territories in raising awareness of breast density and its screening implications through the Canadian breast cancer screening initiative. This initiative is a partnership between the Public Health Agency of Canada and provincial and territorial programs. Through it, we are working with provincial and territorial governments to measure screening program performance nationwide. This means that all jurisdictions regularly share screening program information: lessons learned, best practices, share challenges and mutual questions of importance.

Part of the Canadian breast cancer screening initiative includes the Canadian breast cancer screening database, a national repository on breast cancer screening. Provinces and territories contribute to that database, which is then used to monitor and evaluate screening programs across Canada.

Bill C-314 would require the existing Canadian breast cancer screening initiative to share information on dense tissue in relation to cancer screening and any follow-up procedures. The initiative makes a tool available to assist in decision making pertaining to breast cancer screening. In the future, the tool will include breast density information. Sharing information about ways to improve these programs ensures women receive the full benefits of early detection.

I am pleased to note that our government will also begin discussions through the federal-provincial-territorial national committee for the Canadian breast cancer screening initiative regarding identification protocols for dense breast tissue. Through the committee, participating provincial and territorial screening programs are encouraged to share best practices on raising awareness of dense breast tissue.

The committee also provides opportunities for provincial and territorial governments to collaborate on screening recommendations and approaches. The Canadian breast cancer screening initiative will also continue providing information on breast cancer screening through its biennial report. This information will help to enhance organized screening across Canada.

Moreover, our government continues to take action through the Canadian Partnership Against Cancer, which leads the implementation of the Canadian strategy for cancer control. This made-in-Canada approach, consistent with the bill, has a key role in accelerating effective cancer prevention and control strategies. It also works with and engages the cancer community to provide Canadians with information on screening.

Of interest, the partnership hosts a web based resource called, “Cancer View Canada”. This portal provides information to Canadians on cancer issues, including screening, and it draws on the expertise of partners.

Renewed investments in the partnership, which was announced last March by our Prime Minister, allows the partnership to continue its important work. As members will see, there is much work already started that supports Bill C-314.

The bill also recognizes the important role of the Canadian Cancer Society, the Canadian Breast Cancer Foundation and the Canadian Women's Health Network in providing reliable information to support women's decision making.

The federal government works collaboratively with various stakeholders and will continue raising awareness through these existing initiatives. Canadians do not have to wait to learn about these issues from their doctors. We have a responsibility to provide this current evidence in the most efficient and effective way possible, especially when the lives of Canadians may be at stake.

Through further awareness, Canadian women and their families can become more informed and they will make better decisions. They will also learn about breast density and its implications for screening.

I encourage all my fellow parliamentarians to support this very important bill. It would increase awareness for women regarding dense breast tissue. It is important knowledge to have, not only for them but in the interest of their loved ones. It could even save a life.

I thank the hon. member for Barrie for his concern about this issue and his willingness to ensure we are better educated about our health.

Breast Density Awareness ActPrivate Members' Business

December 9th, 2011 / 1:40 p.m.
See context

NDP

Rathika Sitsabaiesan NDP Scarborough—Rouge River, ON

Madam Speaker, as a woman who, like most Canadians, has had friends and family struggle against cancer, I am proud to be given the opportunity to rise today in the House and state without reservation that I will use my mandate to search for practical and effective ways to fight cancer.

Canadians need first rate prevention strategies that include increased access to doctors, increased access to specialists, better screening, earlier screening, first rate equipment, dedicated funding and better access to necessary medications and progressive research. Access, equipment and funding are the silver bullets that make the most difference in the lives of cancer patients.

As I read the bill before us, I was searching for these targets but, I am saddened to say, I found none. It is not that Canada does not need a bill to help fight against breast cancer, it is that we need a better bill. There are real ways that the government can make a difference and Bill C-314 shirks that responsibility.

First, education and awareness are not enough to combat health care problems. I have seen again and again over the past six months how keen the government is to throw huge amounts of money at educational and awareness campaigns while ignoring the tangible systemic problems that need to be addressed.

Awareness is a first step, and I would never degrade the necessity of education, but what is a woman who discovers that she is at risk for breast cancer to do when she does not have access to a family doctor?

I come from Scarborough—Rouge River, an urban riding in the greater Toronto area. One would think that being in an urban centre, people would not have a problem in terms of access to doctors. However, from the day I was elected, I have heard constantly from my constituents that they do not have family doctors and cannot afford the time and money required to travel to a place where they can see a doctor or a specialist. With the state of public transit being what it is for my constituents, I cannot say that I blame them. I takes two hours one way to go downtown. Would hon. members travel hours and hours on public transit to go to the doctor's office? I know I would not.

Unless the government is willing to back this awareness campaign with federal money aimed at providing women with dense breast tissue direct access to doctors and state of the art screening equipment, such as a digital MRI mammogram machine, then all the education and awareness in the world will not really help these women.

I have witnessed this trend again and again. A federal program will take one shallow step toward addressing the real problem and that is where it stops.

This is a game of optics. The Conservatives want to give the appearance that they are taking action on health care issues, without actually doing anything.

The women of Nunavut do not have a breast cancer screening program at all. This is urgent. This is something that we can do that will have real effect on women's lives.

If the government is serious about preventing breast cancer, then the bill in our hands today would be, among other things, a comprehensive proposal to work with our provincial governments and territorial governments to create a breast cancer screening program in Nunavut. The women of Nunavut and other rural communities in the north are already at risk. They are farthest away from hospitals and are often some of the poorest in our country, as we have recently learned with the community of Attawapiskat and many others. It is utterly negligent for the government to deny them access to basic health care while providing, through the bill, education that says, rightly, that more women should be tested and more frequently.

I would ask the Minister of Health to explain this hypocrisy to the House today and, if she cannot, then to commit to creating legislation that will ensure that Nunavut has equal access to essential health services, as it is their right to have.

My colleagues and I are not alone in thinking that the bill is weak and ineffective. The Canadian Breast Cancer Network is the national link between all of Canada's breast cancer prevention organizations, including the Canadian Cancer Society, the Canadian Breast Cancer Foundation and the Breast Cancer Foundation of Canada, and they do not believe that the bill does enough to enhance screening for women at risk of breast cancer.

I know that the government has a hard time listening to expert advice from those members of civil society who know better than it does, but I beg the government to take note of three major recommendations that the Canadian Breast Cancer Network is saying will make a real difference for Canadian women.

First is new clinical screening machines, MRI digital mammogram machines, that are more routinely used on all women. We must invest in state-of-the-art technology to save cancer patients now. A government that can invest in fighter jets can surely afford the diagnostic machines that have been proven to save the lives of cancer patients.

Second, screening for all women should begin at the age of 40. The government must fund a federal program to establish screening programs for women aged 40 to 49. It is proven that early detection is paramount with breast cancer, and that is why a program that gives women access to doctors and screening before the age of 50 is crucial.

Third, the CBCN has identified that Nunavut must have a breast cancer screening program. We must work with the territorial government to fund this program to reach out to at-risk women instead of demanding that they travel out of territory to receive equal health care.

While the Canadian Cancer Society is, of course, eager for legislation aimed at preventing breast cancer, it has come out and said that this bill will not produce any tangible outcomes for breast cancer patients and their families.

It is also important that we speak to the needs of families when we talk about cancer.

Anyone who has had a family member with cancer, as I have, can tell us how important it is to be supported in the role of an informal caregiver. We do not have enough home care in any of our provinces or territories in Canada; when family members become ill, it almost always falls on their family and community to care for them. This has practical repercussions on people's lives. When I say “support”, I do not mean only emotional and spiritual support for the patient. Although the value of emotional support is unquantifiable in difficult times, Canadians need practical financial support as well.

Alex Jahad, a physician who was the keynote speaker at the CAT conference, said in his address that informal caregivers are the largest invisible majority in health care. They are usually women who are also working and at the same time raising children. Less than one-quarter of these women receive any financial support from the system. In consequence, they themselves will develop chronic conditions and illnesses brought on by overwork and stress.

Dr. Jahad said that the amount of unpaid informal care that takes place in Canada translates to $80 billion to $90 billion of labour. I would therefore like to take this opportunity to remind the House about the NDP's position on increasing access to employment insurance for anybody who must take leave from work in order to take care of a sick relative.

There are real changes that can be made to help fight breast cancer, and we know what they are. The experts have told us what they are. This government is lacking the political will to take serious action. We must fund programs and create the legislation that will have real effects on the lives of Canadians, not just short-term bandage solutions.

Breast Density Awareness ActPrivate Members' Business

December 9th, 2011 / 1:50 p.m.
See context

Conservative

Patrick Brown Conservative Barrie, ON

Madam Speaker, before I get into the essence of the bill, I want to respond to a few of the comments made by the member for Scarborough—Rouge River.

This is a bill on breast cancer screening. I know she is new to this chamber, but a royal recommendation is not permitted in a private member's bill. Funding of doctors is not something one can do through a private member's bill. Therefore, I think it is inappropriate to suggest it is something that could have been added to the bill.

May I also add that it is a bit disingenuous, in the sense that the member for Scarborough—Rouge River is an active supporter of the Ontario New Democratic Party; when it was in power, for the first time in Ontario's history it cut medical enrolment, so the root challenge we face in Ontario, in her riding, exists because of the party she supported when it was in office. If we do not train and graduate doctors, we will not have them in our ridings to work on the many essential medical needs.

With regard to the bill, one in nine women will be diagnosed with breast cancer at some time during their lives. According to the Canadian Cancer Society, over 24,000 Canadian women will have been diagnosed with breast cancer this year alone. Sadly, 5,000 of them will lose their fight.

Cancer care has been a critical issue to me, and when I was presented with the opportunity to present a private member's bill, I knew instantly that I wanted to do something in this field. Every year, thousands of Barrie residents in my riding participate in the CIBC Run for the Cure. It really is inspiring to see so many people who care so much about battling this insidious disease.

While putting thought to this bill, I felt it was important not only for women but for all of us to be aware of the fact that screening for breast cancer can save lives. Providing women with accurate information about screening is therefore important and will ultimately help them make decisions that are right for them. This is the essence of Bill C-314. Breast cancer is more easily treated and, in most cases, curable when found early.

Dense breast tissue is one of the top risk factors for breast cancer, and it is important for women to be informed of this fact. This can be done when they are screened for breast cancer by a mammogram, but women who have breast dense tissue should also know that the potential cancer may not be detected because it cannot be seen on a mammogram and therefore diagnosed by radiologists. It appears white on mammograms and therefore is more challenging to detect.

What Bill C-314 would do is highlight the importance of being informed and work with the provinces and territories through the national screening program in order to ensure that women receive this information.

For many women, especially young women, who have a higher incidence of dense breast tissue, having this information is essential to their decision-making process. This knowledge will provide them with the tools they need to make personal health care decisions.

Women who are informed that they have dense breast tissue may need to go for a different type of screening, such as an ultrasound or an MRI. Possible cancers may be deciphered more readily by a specialist using this type of diagnostic testing.

We are fortunate in Canada to have screening programs for breast cancer. Our provinces and territories deliver these programs to detect breast cancer early, before it has spread, so that treatment can be started. Providing more information through these programs will help women and their doctors make well-informed decisions regarding breast cancer screening. Targeting dense breast tissue is one of the means by which, through this piece of legislation, we can make a tangible difference in the fight against breast cancer.

I know too many loved ones, friends and even colleagues on the Hill, who have been touched by cancer. Through this bill I hope to not only make a difference but hopefully save lives.

I hope I can count on the members of the House to support this private member's bill, Bill C-314.

Also, I am thankful to Andrea Paine, in the Minister of Health's office, for her assistance, and I thank also Dr. Rob Ballagh, from the city of Barrie; Councillor Bonnie Ainsworth; Mike Richmond, from Toronto; and my assistant in my Barrie office, Shawn Bubel, who assisted on the drafting of this bill.

In Barrie we are building a cancer centre right now. This is one of the items I discussed with our CEO, Janice Skot. I appreciate her advice that it is this type of initiative that can really help make a difference.

Breast Density Awareness ActPrivate Members' Business

October 24th, 2011 / 11:05 a.m.
See context

Conservative

Patrick Brown Conservative Barrie, ON

moved that Bill C-314, An Act respecting the awareness of screening among women with dense breast tissue, be read the second time and referred to a committee.

Mr. Speaker, I am very pleased to speak to my private member's bill, Bill C-314, An Act respecting the awareness of screening among women with dense breast tissue, which calls on the federal government to encourage the use of existing federal initiatives in order to increase awareness among Canadian women about the impact of having dense breast tissue and the complications it poses for breast cancer screening.

Breast cancer touches many Canadian women and their families and friends, and is the most common form of cancer in women. I know this is something Canadians from coast to coast to coast care deeply about. Just last month Barrie held its annual CIBC Run for the Cure in support of breast cancer research. I saw 2,000 residents out early on a cold and wet Sunday morning to support the battle against breast cancer. Runs like that occur across the country because Canadians are deeply concerned.

In my community of Barrie, in less than 12 months, the Royal Victoria Hospital's regional cancer care centre will open. There have been literally thousands of fundraising events over the last five years to support this very large cancer centre. It will help battle a variety of cancers, including of course, breast cancer.

This year it is estimated that about 23,000 women will be diagnosed with breast cancer, and 5,000 women will die from this insidious disease. Over their lifetime, one in nine women will be diagnosed with breast cancer. This is very difficult to accept. It touches many women and their loved ones. Sixty-four Canadian women will be diagnosed with breast cancer and 14 will die of breast cancer every day. It is my sincere hope that over time this bill will help reduce those troubling numbers. Health sectors in other areas of the world are beginning to more aggressively target dense tissue to enable early detection of breast cancer.

It is important for all of us to be aware of the fact that screening for breast cancer can save lives. Providing women with accurate information about screening will help them make decisions that are right for them. The federal government supports a number of initiatives to support Canadians dealing with cancer.

Bill C-314 aims to raise awareness about dense breast tissue and breast cancer screening. It will help women and their doctors make well-informed decisions regarding breast cancer screening. It includes a number of elements, which I will briefly outline. I will also address initiatives currently under way to address them.

First, this bill requires the Government of Canada to assess whether gaps in information exist relating to breast density in the context of breast cancer screening. Second, this bill requires that approaches be identified, where needed, to improve information for women in order to: one, address the challenges of detecting breast cancer in women with dense breast tissue; and two, raise awareness concerning these challenges. Third, the bill requires the existing Canadian breast cancer screening initiative to share information on dense breast tissue and its relationship to breast cancer screening and any follow-up procedures that may be deemed necessary.

Canada is fortunate to have screening programs for breast cancer. The provinces and territories deliver these programs to detect breast cancer before it has spread so that treatment can be started. We are learning more and more from scientific research about breast cancer and its risk factors. New and better treatments are being developed. However, there is still much to learn. We know that good information is fundamental to the decisions that each of us makes with the advice of our doctors about our own health. This dialogue is the key to doctor-patient relationships.

Let me take a few moments to explain how the issue of breast density relates to breast cancer screening. First, breast density refers to the amount of tissue in the breast. Dense breasts have more tissue. Breast cancer screening is done using a mammogram, which is an X-ray of the breast. A woman's breast density can affect the accuracy of a mammogram and it may be more difficult for a doctor to see an abnormality. There could be cancer present if the breast tissue is dense because both cancer and dense breast tissue appear white on mammograms.

High breast density is also linked to an increased risk of developing breast cancer, although it is not yet known why this is the case. We also do not know how common dense breast tissue is among Canadian women, although some statistics point to the fact that it could be as high as 40%. Providing women with information of what is known about breast density would help them make well-informed decisions about screening and would open the door for women to engage in follow-up procedures, such as an MRI or ultrasound, if they have dense breast tissue which could skew the mammogram.

In addition to raising awareness on breast density, the bill recognizes the responsibility of the provinces and territories for providing breast cancer screening. Provincial and territorial breast screening programs are invaluable in the early detection of breast cancer in Canadian women.

As noted in the bill, the federal government plays a role in breast cancer screening by facilitating the identification and adoption of effective practices in screening. We also support the sharing of information on screening methods and outcomes through our federal roles in research and surveillance.

Through the Canadian Institutes of Health Research, our government provides funding to researchers to investigate the full spectrum of cancer prevention and control. One of the priorities of the Canadian Institutes of Health Research is early detection of cancer. The CIHR works with partners both nationally and internationally to advance its research priorities, including breast cancer research.

Our government has demonstrated its commitment to breast cancer screening by investing in the Canadian breast cancer screening initiative. We work with provincial and territorial governments to measure the performance of breast cancer screening programs across Canada. This means that all jurisdictions regularly share information on the screening programs and discuss what they are learning. They share best practices, discuss the challenges they are facing and the questions that are important to all of them.

Information sharing about ways to improve these programs ensures that women receive the full benefits of early detection. This includes providing women with information about all aspects of breast cancer screening. The federal, provincial and territorial national committee for the Canadian breast cancer screening initiative provides opportunities for provincial and territorial governments to work together to develop their screening recommendations and approaches. This committee is comprised of medical professionals and key stakeholders.

For example, the committee is currently looking at breast cancer mortality and improving screening for underserviced populations. We have the Canadian breast cancer screening database, which is a source of valuable information on breast cancer screening. Participating provincial and territorial screening programs contribute to the national database, which is used to monitor and evaluate breast cancer screening programs. Non-government organizations play a vital role in this process as well.

I am proud to say that our government is taking action on cancer through our continued investment in the Canadian Partnership Against Cancer which has led to the implementation of the Canadian strategy for cancer control. The partnership is the first of its kind and was established by our Conservative government. It covers the full spectrum of cancer control, from prevention to palliative and end-of-life care, policy to practice, and from research to health system applications.

Together with the cancer community, the partnership is accelerating the use of effective cancer prevention and control strategies. Its objectives are to reduce the number of cancer cases, minimize cancer-related deaths and improve patient quality of life.

In March of this year, our Prime Minister announced renewed funding of $250 million over five years, beginning on April 1, 2012. This will allow the partnership to continue its invaluable work. In the words of the Prime Minister:

We are making progress on prevention, diagnosis, treatment and hope, and in tracking our progress closely, the partnership is leading us on the path to a cure.

The partnership plays a key role in providing information to women on cancer screening, which aligns with the spirit of this bill. The bill also recognizes the important role of organizations such as the Canadian Cancer Society and the Canadian Breast Cancer Foundation in providing reliable information that supports women in making decisions about their health.

All of us are familiar with the Canadian Cancer Society. This national volunteer organization works in cancer prevention, research, advocacy, information and support for all cancers.

The Canadian Breast Cancer Foundation is a national volunteer organization dedicated to working toward a future without breast cancer. The foundation funds, supports and advocates for research, education and awareness programs, early diagnosis and effective treatment, as well as a positive quality of life for those living with breast cancer.

Women's health organizations, such as the Canadian Women's Health Network, raise awareness on many health issues faced by women in Canada, including breast cancer.

Working with the above-listed breast cancer stakeholders, the federal government will continue to raise awareness through existing initiatives on the issue of breast density in the context of breast cancer screening. These stakeholders will be very critical in our battle to raise awareness about breast density.

This bill is particularly timely given that October is breast cancer awareness month. Through efforts to raise awareness, Canadian women and their families can become more informed about breast cancer. They will learn about breast density and its implications for breast cancer screening. They will be able to make well-informed decisions based on this knowledge.

I would like to thank Andrea Paine at the Ministry of Health in Ottawa, Dr. Rob Ballagh of Barrie, Mike Richmond from Toronto, and my assistant in Barrie, Shawn Bubel, for their assistance in the drafting of the bill.

The bill provides an opportunity for the Government of Canada and the House to recognize the critical importance of raising awareness about breast density and breast cancer screening.

It would be an honour for me to have the support of all members in the House for this bill. Too many families have been touched by this form of cancer. I am hopeful that by ensuring women get the information they need which could lead to early detection, this legislation could potentially save lives.

Breast Density Awareness ActPrivate Members' Business

October 24th, 2011 / 11:15 a.m.
See context

NDP

Anne Minh-Thu Quach NDP Beauharnois—Salaberry, QC

Mr. Speaker, first, I would like to congratulate my colleague opposite for his interest in and his work on the fight against breast cancer, particularly cancer in those with dense breast tissue.

To promote breast cancer awareness and prevention, should the government not work with the provinces and territories to reduce the wait times for diagnostic tests and improve access to X-rays in the public health care system?

This would give disadvantaged women better, earlier and fairer access to the breast cancer screening program, since diagnostic X-ray testing is sometimes carried out in private clinics.

Breast Density Awareness ActPrivate Members' Business

October 24th, 2011 / 11:15 a.m.
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Conservative

Patrick Brown Conservative Barrie, ON

Mr. Speaker, I am very proud that this government has worked closely with the provinces and territories to assist in enhancing health care in Canada. Let us not forget that this is the highest level of health care funding in our history to the provinces and territories through this federal government. With an increase of 6% a year we have seen record investments in health care in all areas.

The bill sets out that we would work with the provinces and territories on enhancing the breast cancer screening protocols. I am very proud of what this government has done on health care. It is not limited just to the support for the provinces and territories in this new investment, but with the Canadian cancer partnership and a variety of other partnerships this government again and again does whatever it can to enhance health care in Canada.

Breast Density Awareness ActPrivate Members' Business

October 24th, 2011 / 11:15 a.m.
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Conservative

Cheryl Gallant Conservative Renfrew—Nipissing—Pembroke, ON

Mr. Speaker, the recommended initial age for breast screening as well as the frequency for screening changes from study to study. It also changes from province to territory.

How does a woman know that she is getting the initial screening and the frequency of screening according to need as opposed to according to what a province or territory wants to pay for?

Breast Density Awareness ActPrivate Members' Business

October 24th, 2011 / 11:15 a.m.
See context

Conservative

Patrick Brown Conservative Barrie, ON

Mr. Speaker, that is one of the benefits of the bill. It encourages the sharing and pooling of information. There is a variety of standards, but now with the provinces, territories and the federal government working on the Canadian breast cancer screening initiative, we will start to see more of a balance in terms of protocols.

I also note that the Government of Canada is investing in the CIHR for breast cancer screening. The CIHR has made that an area of interest. There are a lot of things we do not know in terms of breast cancer. That is why the research done by the CIHR is critical, as is having an active dialogue with the provinces, territories and the federal government on breast cancer. Research and surveillance are going to be very much needed as we embark on this battle against breast cancer.

Breast Density Awareness ActPrivate Members' Business

October 24th, 2011 / 11:20 a.m.
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Conservative

Ron Cannan Conservative Kelowna—Lake Country, BC

Mr. Speaker, I would like to thank the hon. member for Barrie for bringing this very important issue to the House. I have three adult daughters. My wife and I were talking about this the other day because of the CIBC breast cancer walk. It is phenomenal to see the number of women who have been able to be screened and have mammograms, and have moved into a new kind of life because of breast cancer.

Why has this not taken place already? Why has it come to this stage? We know there is so much information available. Maybe he could enlighten us as to why it is at this stage and what the process is to get this legislation through the House.

Breast Density Awareness ActPrivate Members' Business

October 24th, 2011 / 11:20 a.m.
See context

Conservative

Patrick Brown Conservative Barrie, ON

Mr. Speaker, we are learning more and more about breast cancer all the time. While it was not clear before, I know that in the U.S. and a few other jurisdictions they realized there were challenges with the screening due to the fact that dense breast tissue was skewing mammogram results. Possibly as high as 40% of females have dense breast tissue, which is a huge per cent of the population that we would have inadequate information on from a mammogram. Other health care jurisdictions are embarking on new screening initiatives, and this is an opportunity for us to learn from each other. Adopting more effective practices would be a very positive step for the Canadian fight against breast cancer.

In terms of why this is has not happened before, it is just that we had not learned about it before. This is something that Health Canada was looking into and it is something that was only started last year in the United States. This is something that was identified as a potential area where we could improve breast cancer screening. It is certainly worthy of the House to look into, if it could potentially save lives of 23,000 females who are, unfortunately, diagnosed with breast cancer every year.

Breast Density Awareness ActPrivate Members' Business

October 24th, 2011 / 11:20 a.m.
See context

NDP

Anne Minh-Thu Quach NDP Beauharnois—Salaberry, QC

Mr. Speaker, breast cancer is one of the most common illnesses among Canadian women. In 2011, an estimated 23,000 women will be diagnosed with breast cancer, and more than 5,000 women will die of it. On average, 64 Canadian women a day learn that they have breast cancer.

A breast cancer diagnosis forever alters the lives of these women. First, there is the fear and anxiety that accompanies the tests, and then chemotherapy becomes a part of their everyday lives. They must miss work and find someone to help take care of their children. Sometimes, a diagnosis can mean surgery and the loss of a breast, along with all of the pain associated with that harsh reality. There is also the exorbitant cost of medications and the red tape of insurance companies. And then there are the women who have no insurance at all and must make sacrifices to get the essential medications they need to fight this illness.

Women need support for the duration of this process. I would like to acknowledge the initiative of the member for Barrie. It is remarkable that a man, who will probably never suffer from this disease, wants to get involved. However, this bill is incomplete. It is but a modest band-aid solution to a serious and complex disease. This bill would encourage the use of existing initiatives. In my opinion, we must do more. Although breast density may be a significant risk factor, it is nevertheless just one factor to be taken into consideration.

First, what is breast density? The member opposite explained it very well. Dense breasts have more connective tissue, glands and ducts. When a woman has a mammogram, the dense tissue appears white, the same colour as cancerous lumps, which can result in a false diagnosis. Other, more precise tests are then recommended. Better results are obtained for these women with magnetic resonance imaging, for example.

However, we must be cautious. Breast density only affects a small number of women. Focusing only on this aspect of the disease will not help improve cancer screening throughout Canada. This bill abandons all other women, the majority, who need better screening and health care measures. I would like to explain what would really make a difference in the fight against breast cancer.

First, the reality is that many women will not discover in time that they have breast cancer, simply because they do not have access to a family doctor, who is often the first contact in the health system. The family doctor knows the patient's history, weight and general health, and asks questions about the patient's lifestyle, nutrition, and so forth. The family doctor does the annual exam and may detect symptoms of the disease or an unusual lump in the breast. He or she may refer the patient to a specialist for tests and further investigation.

More than 5 million Canadians still do not have a family doctor. For years, the people of this country have been calling on governments to address the shortage of doctors. What is the federal government doing? Nothing. My colleagues and I have proposed numerous measures to fix this important issue. One significant way to help would be to work with the provinces to increase the number of spaces in universities in order to train an additional 1,200 doctors. Multidisciplinary teams should also be established to improve screening and patient care.

For example, at the Centre hospitalier de l'Université de Montréal, general practitioners, oncologists, nurses and radiologists work together to treat patients. Early detection has increased because there is constant communication between the various health professionals. In addition, treatment includes psychological services as well as support for relatives.

Second, breast cancer screening is not routine in Canada. Programs are sometimes inadequate or completely non-existent, as is sadly the case in Nunavut. However, specialists are telling us that the earlier the diagnosis, the higher the woman's chances of survival. Studies have shown that women are at a higher risk of developing the disease after the age of 40. The Province of Quebec implemented a routine screening program a few years ago. The program targets women between the ages of 50 and 69, and involves getting a mammogram. Every two years, women are contacted by the department and are encouraged to get tested. The program is fully covered by the Régie de l'assurance-maladie du Québec. According to statistics from Quebec's Department of Health and Social Services, breast cancer mortality rates in participating women dropped by at least 25% between 1996 and 2006.

The federal government should take the lead on this and work with the provinces and territories to ensure stable funding for routine screening programs for women 40 and over. In doing so, lives would be saved.

Thirdly, another major problem is access to diagnostic tests within a reasonable timeframe. New investments in imaging equipment have increased the number of scanners available, but have not necessarily led to shorter wait times, or so says the Health Council of Canada in its May 2011 report. Between 2008 and 2010, wait times for these scans decreased in Alberta and Prince Edward Island and increased in Ontario. Governments continue to face challenges in collecting data on wait times for diagnostic imaging, in part because many scans are done outside hospitals in free-standing clinics.

There is also the question of public coverage for diagnostic testing. Some provinces cover diagnostic tests and others do not. Some provinces provide coverage at hospitals only. In Quebec, for example, tests are covered only if they are done in a hospital. Nonetheless, patients can pay out of pocket to get tested at free-standing clinics. These private-sector tests are done by radiologists who also work in public-sector hospitals, which increases the wait times and creates two classes of people: those who have the means to pay for diagnostic tests and those who do not, the less fortunate. A number of doctors in Quebec, including the MQRP —also known as Canadian Doctors for Medicare—condemn this double standard.

A federal fund for improving public coverage of diagnostic tests, included in the next health report, is certainly one solution to consider. Establishing Canada-wide standards to improve breast cancer screening for certain women, namely women with dense breast tissue, is a concrete measure that would truly help these women. Is the government prepared to commit to such solutions? I hope so.

This government has been very lax when it comes to protecting and funding the public system. Under the pretext that health falls under provincial jurisdiction, the Conservatives clearly seem to think that the best thing to do is nothing at all. However, the federal government is responsible for working with the provinces to improve the health of all Canadians. Do the members opposite need to be reminded that one of the principles of the Canada Health Act is universality. People consider equal access to health care to be a right of citizenship, not a privilege for only the most fortunate.

Fourth, the cost of medication is a serious obstacle to cancer treatment. What is the point of improving breast cancer information and screening if women cannot afford to buy the medication they need to be cured? While the health care system provides cancer-treating drugs in hospitals, half the new treatments are taken at home and patients are therefore responsible for paying for them. A lack of insurance means enormous costs for patients and their families given that the average cost of treatment for new cancer-fighting drugs is exorbitant at $65,000. Some people do not have insurance since they do not have the money to pay for a private policy.

Under the current health accord, which was signed in 2004, the federal and provincial governments agreed to create options for catastrophic pharmaceutical coverage. Since then, nothing has been done. What is the federal government waiting for to resolve this issue? Does the government have no idea how to reduce the cost of medication?

I have a few ideas. First, make better use our negotiating power when purchasing pharmaceuticals, specifically by joining with all the provinces and territories to buy in bulk. After all, there is strength in numbers. Second, reduce the administrative costs by making use of the public system. A Canada-wide catastrophic drug program would be less costly to administer than several small programs in the private sector. Third, eliminate rebates for pharmaceutical companies and pharmacists and provide funding for research based on the actual needs of the public rather than on profits for pharmaceutical companies.

Finally, breast cancer prevention could be greatly improved. This disease has many risk factors: personal and family history, obesity, and the use of alcohol and tobacco can increase the risk of breast cancer.

I hope that all these good ideas will help the members of the House to understand what a terrible illness breast cancer is. Although this bill has good intentions, it does not do enough. Nevertheless, we hope that the members opposite will propose a better and stronger Canada-wide strategy that will help all women suffering from breast cancer rather than just a few of them.

Breast Density Awareness ActPrivate Members' Business

October 24th, 2011 / 11:30 a.m.
See context

Liberal

Hedy Fry Liberal Vancouver Centre, BC

Mr. Speaker, I rise to speak in favour of this particular piece of legislation, but I would also like to make some further comments with regard to it.

The Liberal Party supports any efforts to increase awareness with regard to illness and research, to provide more information to Canadians, and to deal with screening issues. That is a given. We all agree with that and believe we should be doing this in many other areas. There are a number of areas within health promotion and disease prevention wherein the federal government could take a lead as well as an active approach to ensure that 60% of preventable diseases are prevented. There are broader issues we should be looking at rather than this one particular issue, but it is a start.

The federal government has signed an agreement on a pan-Canadian approach to breast cancer. If the legislation says that the federal government has a leadership role to play with regard to an issue like breast cancer, then it must also look at a pan-Canadian approach to many other things.

My colleague who spoke last talked about a pharmaceutical strategy. The 2004 health accord said that we need a pharmaceutical strategy because many Canadians do not have access to lifesaving drugs and drugs required to treat chronic disease. Drugs cost a lot of money and many people cannot afford them.

We must discuss how to implement some of the really important issues in the health accord that require federal leadership. The federal government cannot say that on the one hand it wants to lead pan-Canadian approaches regarding one issue, but on the other hand it does not want to do it regarding another issue. That would not be a reasonable or logical response to anything.

There is a huge role for the federal government to play in ensuring that no matter where Canadians live in this country they have access to the health care services they require when they need them and that in many instances they have access to integrated services that would prevent them from getting diseases. That would provide huge savings to the health care system. It would also help deal with disease chronicity which would help keep people out of hospitals and increase savings and cost-effectiveness in the system.

There are many things we must talk about if we want to open the door to a pan-Canadian approach. I am glad to see that the member has brought this forward. I hope his party will listen to him. I also hope that the government will take a pan-Canadian approach toward many necessary issues.

The bill calls for the federal government to work with the provinces and territories to increase awareness among women with regard to dense breast tissue. The issue I want to flag here is that while we want to increase awareness, which is a very positive step, we also want to be careful that we do not create anxiety among women who have dense breast tissue because there is not much evidence to show that the screening detection methods such as MRIs, et cetera, will give the wanted outcome and save lives.

There is one important thing to remember in terms of breast awareness and in terms of preventing breast cancer. It is not the yearly doctor visit for a breast examination that is so important, nor is having an MRI . What is important is that a woman examine her breasts every month at the appropriate time.

Many people would ask how that monthly self-examination would help. If a woman examined her breasts monthly she would know what they normally felt like or how they felt the last time she had tests done and she was told her breasts were fine. I am not only talking about breasts. When a woman screens herself on a monthly basis she knows what is normal for her body. Therefore, any change she discovers will be a flag that something new has occurred. It may not be anything she needs to worry about but it will at least cause her to initiate a visit to her physician for investigation.

It is important for women, especially those who have dense breast tissue, to understand that self-examination is one of the most important things they can do for themselves. We can say the same thing with regard to men and testicular cancer, et cetera. Awareness is important.

I would like to see the federal government's role expanded in the bill to suggest that it could and should be a clearing house for best practices.

For instance, British Columbia has a solid record in this country for having the highest survivor rates and lowest death rates with regard to breast cancer. That is not only because of early screening but also because of an integrated approach wherein researchers and individuals dealing with genomics as well as individuals from the cancer society and the cancer agencies work together as an integrated team. It is important to emulate those best practices which give us best results. Therefore, another role for the federal government would be to take on a pan-Canadian approach by looking at some sort of clearinghouse on many issues.

Unlike the California bill, the bill does not create panic. It does not recommend that women should run out and demand MRIs or further screening. That is good because I would stress there is no evidence that this would help. However, what this bill is suggesting is important and necessary is increased awareness and discussion to help women understand what it is they need to do. Identifying gaps in information and improving information for women is and always will be a good thing.

This year 234,000 women in Canada will be diagnosed with breast cancer of which 5,100 will not survive. Those are very staggering figures. Many of these women are at the peak of their lives and may have children. It is important that they be prompted to exercise methods of prevention wherever necessary.

With regard to not causing panic, we must ensure women are aware that having access to an MRI is not an internationally based clinical guideline and that it does not create a sense of entitlement among women who have dense breast tissue that they should automatically be sent for MRIs. If that is not clear in the bill, it could create panic among these women which in turn could cause an inappropriate drain on health care system resources.

However, the bill is a beginning. If the federal government is interested in pan-Canadian approaches, which is a good idea, it is important that more research be performed to provide better information to women who are at risk of breast cancer. The Canadian Institutes of Health Research is there to increase that research. We need to work with conditions more often to determine what are best practices. It is important that the federal government accept this, follow through on it and use it as a template with regard to how it can deal with many more issues.

I go back to the 2004 accord. My colleague made the important point that parts of that accord have not received the federal leadership nor political will necessary to provide good outcomes in health care and an effective use of the system. We know the medicare system is sustainable but we must ensure there is a pan-Canadian integrated approach to provide transformative change within the system.

The bill is a start. It flags the fact the federal government cannot say that it is a provincial jurisdiction which will create a precedent for it to not only work with provincial governments but also take on political and leadership roles that will benefit all Canadians.

Breast Density Awareness ActPrivate Members' Business

October 24th, 2011 / 11:40 a.m.
See context

Calgary Centre-North Alberta

Conservative

Michelle Rempel ConservativeParliamentary Secretary to the Minister of the Environment

Mr. Speaker, first, I thank my colleagues for their excellent debate on this issue this morning.

I rise today to address Bill C-314, an act respecting the awareness of screening among women with dense breast tissue. I thank my colleague, the member for Barrie, for bringing this important bill forward.

As October is Breast Cancer Awareness Month, it is time to draw attention to breast cancer and to raise awareness of this important health issue affecting Canadians.

Statistics tell us that breast cancer is the most common form of cancer among Canadian women. One in nine women will be diagnosed with the disease.

Those statistics are more than just numbers. They represent women whose lives are affected by breast cancer. They are wives, mothers, daughters and friends. This year it is estimated that thousands of women across the country will be diagnosed with breast cancer and that approximately 5,000 women will die from the disease.

Thankfully research is providing answers to many questions regarding breast cancer. We are learning more about prevention, risk factors and treatments. Our government's investments into health research through the Canadian Institutes of Health Research support scientific discoveries regarding all types of cancers including breast cancer. We are learning more about the early detection of breast cancer.

The bill focuses on raising awareness regarding breast density and its effects on breast cancer screening. It emphasizes the importance of this issue in an effort to help women and their doctors make well-informed decisions with regard to breast cancer screening.

Why is that important? More than ever before Canadians are taking an active role in their health and require good information to support that role. Canadians need information on what has been proven as well as what is not yet well understood. Only then can they weigh the risks and benefits of the different courses of action.

As well, the Internet revolution allows Canadians to find a great deal of information on health topics. It also means Canadians are faced with the difficulty of deciding what is accurate, inaccurate, important or misleading.

Therefore, providing accurate information to Canadians will increase their awareness and help them make well-informed decisions.

There is a great deal of information available on breast cancer and breast cancer screening which addresses the particular issue of breast density and its implications on breast cancer screening.

A mammogram is an X-ray taken of the breast and is used as a screening method for breast cancer. However, for women with dense breast tissue it can be more difficult for this method to detect small changes that could denote cancer.

Canada's breast cancer screening programs are delivered by the provincial and territorial governments under their jurisdiction for health care delivery. These excellent programs operate according to the highest standards. The federal government is helping breast cancer screening programs through investments made in the Canadian breast cancer screening initiative. This initiative measures the performance of breast cancer screening programs across the country. The information is used by those programs to improve the services they provide to Canadian women.

We are also assisting breast cancer screening programs in sharing their best practices. A key feature of these programs is the important information they provide to women on all aspects of breast cancer screening including breast density. That way we can build on the good work that is already under way.

National non-governmental organizations and their volunteers also play integral roles in raising awareness. The bill recognizes the important role of organizations, such as the Canadian Cancer Society and the Canadian Breast Cancer Foundation, as well as numerous other women's health organizations. All of these organizations work to promote cancer prevention, early detection, effective treatments and research. They also provide education and awareness programs and work to improve the quality of life for those living with breast cancer.

The fact that so many Canadian organizations and programs already provide high quality information to women on breast cancer reflects upon the dedication that exists with regard to this enormous health challenge. Researchers, doctors, nurses and provincial and territorial cancer agencies are committed to reducing the rates of breast cancer.

Our government's investment in the Canadian strategy for cancer control and its implementation by the Canadian Partnership Against Cancer is part of this national commitment. As its name implies, the partnership is working across the country to speed up the use of effective approaches to cancer prevention and control so that all Canadians will benefit. It is helping to fill gaps, build new models and expand existing programs where needed. Cancer screening is one of the partnership's priorities and its work to provide information to Canadians is consistent with the intent of the bill. The renewed investment in the Canadian Partnership Against Cancer announced by our Prime Minister in March will help that excellent work that is under way continue.

We have much to build on and many best practices to apply as we continue to support Canadian women in accessing the information they need to make decisions on their health. Of course, our efforts are in line with the role of the federal government in supporting health research and identifying best practices in creating partnerships and of promoting the health of Canadians.

In closing, Bill C-314 encourages the Government of Canada to use existing initiatives to raise awareness of breast density in the context of breast cancer screening. This is important for Canadian women.

I sincerely hope we have the support of all members in this House for this important bill.

Breast Density Awareness ActPrivate Members' Business

October 24th, 2011 / 11:45 a.m.
See context

NDP

Djaouida Sellah NDP Saint-Bruno—Saint-Hubert, QC

Mr. Speaker, I would like to take this opportunity to congratulate the member for Barrie on his bill. October is Breast Cancer Awareness Month, and his bill's noble objectives are most appropriate.

On this side of the House, and I am sure on the other side as well, we recognize the impact that breast cancer has on the people of Quebec and Canada. This disease is unfortunately all too common. The statistics do not lie: one out of every nine women will suffer from breast cancer in her lifetime. What is even more tragic is that one out of every twenty-nine women will die from breast cancer. The considerable progress that has been made in recent years in research, treatment and screening has significantly lowered the breast cancer mortality rate.

Breast cancer is still too common among Canadian women. I should also point out to the House that, although it is less common, breast cancer can also affect men. An estimated 23,000 women will be affected by this type of cancer, not to mention the thousands of loved ones and caregivers who are also affected. The disease also has high social and economic costs. There are other human costs associated with this terrible disease: the loss of income can be devastating. Many couples do not survive these challenges, and loved ones become caregivers but receive little support from this government.

The bill introduced by my colleague opposite addresses a very particular issue: cancer in women with dense breast tissue. This is a real problem. Recent research has shown that dense breast tissue is a factor as important as age in the risk of breast cancer. Higher tissue density also makes breast cancer screening more difficult. During a mammogram, tumours and high-density masses in the breast both show up as white spots. It is much more difficult for women with dense breast tissue to get quick diagnoses with traditional equipment.

It is also important to bear in mind that problems linked to dense breast tissue are not likely to diminish; quite the opposite. Studies have shown a link between being overweight or obese and denser breast tissue. I do not need to remind this House that the issue of excess weight has reached epidemic proportions in Canada. We can only assume that an increasing number of women will have dense breast tissue in the near future and that this trend is on the rise.

Once again, I would like to say how much I appreciate that the member for Barrie has brought this issue forward so that we can discuss it today. Awareness is always a positive initiative. It makes women more vigilant and ensures that health care professionals are better informed. Everyone supports awareness—it is a noble objective and a just cause, but it is merely one element of treatment. In my mind, this bill is pointless. It does nothing concrete for women who have or will have breast cancer. It does not ensure better access to a health care system that is so desperately lacking in its current state.

I am a doctor myself. I decided to go into politics to make a difference. Many causes are important to me, such as the recognition of foreign credentials—which affects me personally—the status of women and immigration. But health is at the top of that list. I know that the people of Saint-Bruno—Saint-Hubert elected me because they believed in the NDP message that we will work for them. I am worried that this bill, while noble and having created the opportunity for debate, will not make a real difference in the lives of the people of Saint-Bruno—Saint-Hubert, Quebec and Canada.

One of the issues my constituents talk to me about is access to a family doctor. This bill has nothing to offer people who do not have a family doctor. This bill will not improve access to our health care system. We know that a timely diagnosis helps significantly increase the chances of survival. Without access to a doctor, many Canadians will not have access to this timely diagnosis. Wait times for mammograms are also far too long in many places in Quebec and Canada. Those are two significant factors that are not addressed in this bill that would help improve treatment, survival rates and quality of life for breast cancer survivors.

That is why the people of Saint-Bruno—Saint-Hubert voted for me. They want their daily lives to be better. They are demanding better access to health care, and rightfully so. Despite the good intentions of the hon. member for Barrie, this bill does nothing for the Canadian general public.

The hon. member for Barrie was right when he said in the preamble of his bill that the provinces are responsible for the delivery of health care. I agree with him, but I would like to remind him that he is wrong to think that his government has no responsibility in this. The federal government currently has a funding agreement with the provincial and territorial governments. Under that agreement, the different governments agreed to certain specific objectives.

This tool could be used to achieve the objectives of developing better breast cancer diagnostics and treatment for women with dense breast tissue. This is an agreement the provincial and territorial governments, including that of Quebec, signed on to. Why does the member opposite not encourage his government to get on board? We could achieve better concrete results that way.

Perhaps the member for Barrie does not believe that the 2004 health accord is the right tool to allow us to meet these objectives. If that is the case, the 2004 health accord gives his government certain tools to determine whether the accord's objectives have been met, whether the funds transferred are being used in the manner agreed upon by the federal, provincial and territorial governments, and whether the funding is achieving the expected results. It is important for his government to be able to tell Quebeckers and Canadians whether the health accord, which will expire in 2014, is delivering the promised results. Such an accountability exercise, one to which Canadians are entitled, would be the first step in determining needs and the model that will be negotiated in good faith and in partnership with the provincial and territorial governments, including the Government of Quebec, of course. I therefore invite the hon. member to exert pressure on his government to report back to Canadians on the results of this accord and to begin discussions in order to ensure funding for our health care system and for the objectives negotiated for the well-being of all Canadians.

I would also call on the members opposite to address the underlying causes of the problem. I mentioned earlier that women who are overweight or obese are more likely to have dense breast tissue. Women who smoke and who have low levels of physical activity are also at higher risk of developing breast cancer. The Canadian Institute for Health Information indicated in a report that socio-economic status and poverty are significant social determinants of obesity. The Canadian Council on Learning has confirmed that smoking and low levels of physical activity are related to poverty and a lower socio-economic status.

I therefore invite the hon. member for Barrie and this government to address the employment problems facing Canadians, to implement measures that will help the people of Canada to live in dignity, and to find ways to help families in our ridings so that they do not have to live paycheque to paycheque in order to be able to buy groceries.

Quebeckers and Canadians do not have better jobs than they did two years ago. In addition, young people are once again more affected by unemployment than the Canadian average. Furthermore, the number of children living in poverty is not decreasing, far from it. This government's lack of action in this regard is negatively affecting the health of young people. Action must be taken immediately.

I would like to close by saying that I support the principles of this bill. In order to help all Quebeckers and Canadians, we must find a way to improve access to doctors and reduce wait times for the diagnosis and treatment of various illnesses.

Breast Density Awareness ActPrivate Members' Business

October 24th, 2011 / 11:55 a.m.
See context

NDP

Marie-Claude Morin NDP Saint-Hyacinthe—Bagot, QC

Mr. Speaker, I would like to begin by saying that I fully support a plan for breast cancer screening. I salute the member opposite for his initiative.

We all know that this disease claims the lives of far too many people and that many deaths could be avoided with early detection. We also know that women with dense breast tissue are four to six times more likely to develop cancer, which requires timely screening. Although we approve a complete breast cancer screening program for women with dense breast tissue, this bill is vague and clearly lacks substance. In addition, it will not have any tangible effects. Health care workers and women concerned need more than just encouragement to raise awareness and promote best practices. Once again, the government is failing to provide leadership. When will there be a funding and implementation plan for a real national strategy to improve breast cancer screening?

It is also important that we not neglect other forms of cancer and diseases that could be prevented with screening that is quick, accurate and, above all, accessible to everyone. Under the 2003 and 2004 health accords, the government made the following commitments: reduce wait times and increase the number of doctors, nurses and health professionals.

With this bill, the government is attempting use a band-aid solution to hide the commitments it did not fulfill. Seriously, are we really going to prevent breast cancer by encouraging women to be tested? What about women who do not have access to a family doctor and those who must wait six months for a second test? Everyone realizes that cancer can grow a lot in six months, and I know what I am talking about.

This bill should include the following measures, otherwise it does not serve any purpose, other than being a waste of paper. There must be adequate funding to create systematic breast cancer screening programs. These programs should be free for all women and men, since men can also get breast cancer. Particular attention should be paid to women aged 40 and up. There must also be standards for existing programs to help the provinces that already have a plan. There must be a plan for the particular issue related to screening for women with dense breast tissue. We must also work with Nunavut to help the territory implement its first screening plan. We absolutely must ensure that the entire Canadian population has access to a family doctor and to specialists within a reasonable period of time. We must also give general practitioners, gynecologists and oncologists the tools they need and the necessary equipment to conduct tests within a reasonable period of time.

I remind members that more than 5 million Canadians do not have access to a family doctor. That is what we should be addressing. We know that the earlier a cancer is detected, the more effective treatment will be. This applies to all forms of cancer. This government often neglects research, development and innovation. A lot of studies are currently underway but are underfunded. I do not think it is hard to understand: if we invest strategically in research, we can solve a number of problems at every level.

We must also make considerable investments in psychological care for people who are diagnosed with cancer and their families. Cancer affects most families in Canada, directly or indirectly. Even if we implement prevention programs, we also need assistance programs for people who are living with cancer.

Breast cancer is the most common form of cancer in Canada. It is crucial that patients and their families receive support as they fight this terrible disease. We need to do more than simply create awareness and encourage screening. Organizations that fight against breast cancer agree that this bill does not bring significant improvements to screening measures for the women who are most at risk of developing breast cancer. They know what they are talking about. The Conservatives seem to think that this is another area of health care where the federal government has no role to play.

I will say it again—the government needs to take a lead role in health care issues and it needs to work with the provinces. In fact, what we need are large-scale improvements in existing screening programs. Of course, that includes better funding, as I have said before, along with clear standards and the establishment of screening programs in all regions of the country.

The NDP has long been calling on the government to play a fuller role in primary health care and preventive care. Obviously, breast cancer screening measures should be part of that.

A number of groups share our opinion. And I think that the government should listen to them from way up there in its ivory tower because they are the ones on the ground who know the issue.

Quebec's association of hematologists and oncologists says that while it is important to increase breast cancer screening, we cannot forget about other kinds of tumours. Improvements need to be made in the prevention of and screening for all cancers. We must not concentrate all our efforts on one group of women or one type of cancer.

The MQRP and Canadian Doctors for Medicare are saying that we have to ensure that patients have timely access to general practitioners and specialists in order to undergo the necessary tests to get a timely diagnosis. As I was saying earlier, cancer spreads quickly. Access to the health care system, according to the MQRP, to me and to the NDP, is the key solution in battling breast cancer and significantly increases patients' chances of survival.

Dr. Maté Poljicak, a surgical oncologist and director of an interdisciplinary team of breast cancer specialists at the Centre hospitalier universitaire at the Université de Montréal, says that in some cases, such as those for women with dense breast tissue, mammography is not an effective breast cancer screening method. MRIs and much more advanced imaging screens are needed in those cases.

The Canadian Breast Cancer Network, which is run by cancer survivors, does not believe this bill could improve screening procedures for women at greater risk of developing breast cancer.

This network is calling for—

Breast Density Awareness ActRoutine Proceedings

October 3rd, 2011 / 3:10 p.m.
See context

Conservative

Patrick Brown Conservative Barrie, ON

moved for leave to introduce Bill C-314, An Act respecting the awareness of screening among women with dense breast tissue.

Mr. Speaker, this enactment would require the Government of Canada to encourage the use of existing initiatives in order to increase the awareness of women about the implications of dense breast tissue for breast cancer screening and to assist health care providers in making well-informed decisions regarding screening.

According to the Canadian Cancer Society, in 2011 it is expected that over 23,000 Canadian females will be diagnosed with breast cancer, of which, regrettably, over 5,000 will pass away.

The Government of Canada can certainly play an effective role in the adoption of effective early detection screening practices. Targeting dense tissue is one of the means by which we can make a tangible difference.

(Motions deemed adopted, bill read the first time and printed)