Thank you very much.
I'm a professor at the Dalla Lana school of public health at the University of Toronto, and I'm grateful to the federal government. I hold the Canada research chair in breast cancer, which I've held for the past 21 years. I've been a professor at Women's College Hospital and, for 25 years, have focused almost entirely on breast cancer.
One of my topics of interest is early detection and screening. In 2014, I published what was considered kind of a landmark paper. I was the senior author responsible for the statistical analysis and the write-up of the Canadian national breast cancer screening study, which was a study of mammography.
In that study, which started in 1983, we took 90,000 women across Canada and randomized half of them—by chance, randomly—to a mammography every five years. The other 50% received a physical examination. We followed them for 25 years, and I published in 2014 with my mentor, Dr. Tony Miller. After the 25 years of follow-up, we saw almost exactly the same number of deaths from breast cancer in those women who received five mammograms—500—as in those who received no mammogram—505.
That led me to the conclusion that mammography was capable of early detection. The mammographically detected cancers were smaller. They were less likely to be node-positive cancers. Also, the survival of the women with the mammogram-detected cancer was much better, but unfortunately it didn't result in any reduction in the number of deaths.
In fact, there were 177 women who had their nonpalpable breast cancer detected by the mammogram—they found the breast cancer by the mammogram—who were alive at the 30-year mark. I believe that 177 of those women thought the mammogram had saved their lives and would testify to it and do a testimonial saying, “We really believe in mammograms. I had a mammogram and it caught my breast cancer before it was palpable, before you could feel it as a mass.” However, the number of deaths was the same.
The study has been criticized. To a large extent, people criticize that which they don't like. I've written hundreds and hundreds of papers—730 papers on breast cancer—and that was probably the one that had the most response to it, I think largely because we showed that we didn't believe mammography was capable of reducing mortality from breast cancer. A lot of allegations were made against the paper, generally in the lay press.
Anyway, I took the allegations seriously, went back to the data, reviewed all the data as to whether the allegations were consistent with the findings and came to the conclusion that they were not. I hold the paper to be the standard of scientific research. I think it remains the best breast cancer screening study done, and I think the results are valid.
I could go on, but is that my five minutes?