I can tell you that the Canadian practice has been a patchwork of guidelines. Some provinces have been screening women in their forties by allowing self-referral since the program started, like in British Columbia, Nova Scotia and Prince Edward Island. Others have come on board. Currently, as of this date today, that's all the provinces and territories except Nunavut, which does not have a screening program, and Quebec, which is looking at the evidence for screening women in their forties. Manitoba is the only one that has not adopted this policy for self-referral for women in their forties. Alberta starts at 45. The other provinces all start at age 40.
We have had the opportunity to study this differential. What we've shown, in this large study done with Statistics Canada, is that the women who have been diagnosed through screening in their forties in these provinces that have been screening have a significantly higher rate of early-stage breast cancer, and the provinces that do not include those women in their forties have significantly higher rates of those more advanced cancers at stage 2, stage 3 and stage 4. There's also a differential in approach to density.
This is the opportunity we have for the guidelines to make a more standardized approach, and one of the reasons we're so disappointed with the draft guideline.
Thank you.