Evidence of meeting #115 for Status of Women in the 44th Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was task.
A recording is available from Parliament.
Liberal
Advocacy Manager, Prevention and Early Detection, Canadian Cancer Society
Yes.
Liberal
Chief, Population Oncology, CancerCare Manitoba
Yes. Just very briefly I wanted to note that I really would encourage people to go and have a look at the task force's website. They did collect information on the feedback they had from people, including their responses. As you know, these are draft guidelines, and right now they are currently open.
When you look through, I think you'll see they have been quite transparent about the studies that they included and didn't include, and they've expanded their look. I think actually that's one of the reasons why the discussion around 40 to 49 has actually been more on the table now in terms of enabling people to have those conversations. I just wanted to encourage that.
Liberal
Anita Vandenbeld Liberal Ottawa West—Nepean, ON
I'm so limited in my time, and I did want to go to Dr. Appavoo because you—
Conservative
The Chair Conservative Shelby Kramp-Neuman
Anita, I'm sorry to share with you that I tried to get in an extra 30 seconds but it's not working.
Because of the efficiency of all of you around the table, we do have time for an entire fourth round, so I'd like to start.
Anna, you have five minutes.
Conservative
Anna Roberts Conservative King—Vaughan, ON
Thank you, Madam Chair.
I'm going to ask everyone a simple question: Do you consider it to be a risk, as according to the task force, to have a family history carrying the mutation gene of BRCA1 and BRCA2 or to have dense breasts? If everyone could just say yes or no, that would be great.
Conservative
Chief, Population Oncology, CancerCare Manitoba
No, I do agree. I just want to note that it is increased risk. Those are not average risks, which is what the guideline—
Conservative
Anna Roberts Conservative King—Vaughan, ON
Okay, that's increased risk.
Would you agree, if that is the case, there should be mandatory genetic testing, yes or no? I'd like just a yes or no from everybody.
Professor of Radiology, Faculty of Medicine, University of Ottawa, As an Individual
No, I think risk assessment should be done. That's very important, but not necessarily genetic testing.
Conservative
Anna Roberts Conservative King—Vaughan, ON
Okay. I just did some research with the Cancer Society. Breast cancer is the second cause of cancer death among women. It is 25% of new cancer cases in females. In 2024, it is estimated that 5,500 Canadian women will die, so 15 women will die of breast cancer every day.
This is something I think all women—all of us—feel: In order to prevent the mortality rate, we should push the task force to increase the testing at age 40. Does everybody agree with that?
Professor of Radiology, Faculty of Medicine, University of Ottawa, As an Individual
If I could just make a comment, unfortunately, the genetic testing only identifies 50% of women at high risk, and the majority of women do not have any risk factors that would tell them they're at high risk. They wouldn't carry the genetic mutation, but they would still get breast cancer.
Risk assessment is what we're recommending, starting at age 25 to 30, as a way to demonstrate when they should start screening. I think that is really an essential component that we should be recommending, and this guideline did not address that.
Thank you.
Conservative
Anna Roberts Conservative King—Vaughan, ON
Would you say that the task force needs to be updated with the more pertinent information? I'll be quite honest with you, as a woman, these numbers scare the hell out of me. I think I'd rather know early how I prevent cancer or how we can detect it in the early stages, so that I have a long enough life to see my grandchildren grow.
Anyone can answer.
Head, Surgical Oncology, CancerCare Manitoba
If I can start, I think we have to look at.... We all, everyone around here, want there to be no breast cancer deaths, and so how do we achieve that? Screening has a very important role in that, so does advancement of treatments. I think there is a role for certain populations to have better access to genetic testing and prevention.
Prevention itself has been largely understudied, and poorly studied, in breast cancer, but just the task force recommendations themselves are a very limited single tool. Whether or not we should move from 50 to 40, we have a multitude of different views around that, which I won't get into for brevity, but I think it's always important to know that, actually, over 90% of women with breast cancer in Canada will be cured. It is—
Conservative
Anna Roberts Conservative King—Vaughan, ON
Okay—not to cut you short, but I do have limited time. I'm so sorry.
Is there a fee for genetic testing?
Conservative
Head, Surgical Oncology, CancerCare Manitoba
Yes, if you want private genetic testing.... If the government pays for it, each government will have a different amount for not the fee to patients but how much it costs them. In my practice, I do counsel patients who aren't candidates for provincially funded [Technical difficulty—Editor] testing to pay for it themselves. In the two groups that I tend to lead them towards, the last time I looked, it was $299 U.S. and that is a common ballpark for genetic testing that someone would pay for out-of-pocket at a medical-grade lab.