Status of Women Committee on Oct. 21st, 2024

[Milena Gioia]

Absolutely. That's already the case in accessing any kind of medical care. Gender-diverse people don't use their pronouns, or pronouns are not asked for, so of course, that would add another level of complication for people in trying to access, for example, mammography.

[Leah Gazan, NDP, Winnipeg Centre, MB]

You brought up the point that this study hasn't been very inclusive, and I'll accept that, especially because of what we've heard around certain groups, for example, Black women, being at a higher risk of getting breast cancer. If either you or Jennifer Beeman would like to answer, you spoke more specifically about Black women and indigenous women.

I'm also concerned about the fact that the current technologies are not accessible to the disability community. Can you expand on that and on how it places the disability community at risk? I'm concerned about it because if we're not being inclusive in the study, then we're missing really critical points in the research to bring thoughtful and well-informed recommendations forward.

Could either one of you answer that?

[Milena Gioia]

You can go ahead, Jennifer, if you like.

[Jennifer Beeman]

In the case of accessibility for women and AFAB people with disabilities, particularly mobility disabilities, I've known about this for 30 years. We were approached by a very important disability group in Quebec to join a campaign to mobilize groups to get support, because the question of accessibility hadn't changed. Anyone who has had a mammogram knows you have to stand up. Presumably, there are other ways to do this. There was a big mobilization, and we couldn't get a meeting with the health minister to take this on. I don't know how this plays out in other provinces, but these voices need to be heard, because already there are problems of access for many people.

Thank you for the question.

[Leah Gazan, NDP, Winnipeg Centre, MB]

Thank you.

I'm concerned because, first of all, we have a task force, it seems, that has no experts on it in the area. It's not diverse. In most of the research that has been done, I think over 90% were Caucasian women. We're making decisions about breast cancer based on this information, and then it seems like we're doing a similar thing in this study. I'm a bit concerned now. I just want to say that I appreciate this, and I feel that we need more information about it.

[The Chair, Conservative, Shelby Kramp-Neuman]

Thank you, Leah.

At this point, we will begin our second round.

Dominique, you have five minutes.

[Dominique Vien, Conservative, Bellechasse—Les Etchemins—Lévis, QC]

Thank you very much, Madam Chair.

I thank the witnesses for making themselves available today to further enlighten us about breast cancer and early detection.

Ms. Ippersiel, thank you for being with us. That’s very kind.

I’m interested in the studies you mentioned involving the saliva test. My understanding is that it’s currently under development at the Centre hospitalier de l’Université Laval or CHUL. A doctor is leading that study.

What’s the reaction to this scientific breakthrough?

I know we want to screen women for cancer when they’re younger, based on factors other than age. If we could convince those in charge to start screening people between the ages of 40 to 50, that would be a good start.

What’s the reaction from the scientific community, the government or INESSS, which is the Institut national d’excellence en santé et en services sociaux for Quebec?

[Karine-Iseult Ippersiel]

I can tell you that the foundation looked at several health authorities, including INESSS and the ministry of health. We know that they’re aware of the study and that they’re following it closely, because it’s coming to an end shortly, with conclusive results and data. They will be published in the near future.

Health authorities are also waiting for the results so they can make their decisions and determine next steps. Obviously, the foundation is working very hard to turn this into clinical field research, so that we can administer the saliva test and questionnaire to a specific population, as part of a pilot project, to see the effect outside of clinical research and more broadly, down here on earth, so to speak.

Certainly, everyone knows about it and it’s on their radar.

[Dominique Vien, Conservative, Bellechasse—Les Etchemins—Lévis, QC]

It’s true that Quebec is usually at the forefront of social issues. Having been a member of the Quebec government for quite some time, I can attest to that. In this case, we’re closer to the back of the pack.

We’re hopeful that the Institut national d’excellence en santé et en services sociaux, or INESSS, will move forward; however, for you, at the Quebec Breast Cancer Foundation, have you been in contact with the Quebec government or the Quebec minister of health, Christian Dubé? What steps have you taken, and how were you received?

[Karine-Iseult Ippersiel]

I’m not at INESSS, so I don’t know when they’ll release their report. I do know that they follow the Canadian Task Force on Preventive Health Care when making their own decisions.

Then, of course, there are resource issues in Quebec. It can take anywhere from 10 to 33 weeks or even 38 weeks to get a mammogram, depending on where you live. The Foundation has been very vocal on this issue for years. We spoke to Minister Dubé’s office about it, and the message was well received, as well as by the Centre intégré de cancérologie and all the organizations with which we met.

As I said, this study is concluding shortly, so the results should be published soon. We’re waiting for them all. I hope we’ll be able to run a pilot project in the field.

[Dominique Vien, Conservative, Bellechasse—Les Etchemins—Lévis, QC]

Ms. Ippersiel, what does the foundation think about the task force that examined the guidelines? There doesn’t seem to be many fans among the witnesses we’ve met. Dr. Appavoo made a heartfelt appeal to us earlier, when she asked that the task force be abolished and the guidelines suspended.

What’s your opinion of the task force? Should we shelve it and review its mandate, or get rid of it? What’s your position?

[Karine-Iseult Ippersiel]

Obviously, it's not up to the Quebec Breast Cancer Foundation to set up working groups. Rather, that's up to the government. We're watching what these working groups are doing, we're waiting for the answers and we're trying to see—

[Dominique Vien, Conservative, Bellechasse—Les Etchemins—Lévis, QC]

Based on your observations, what's your assessment of them?

[Karine-Iseult Ippersiel]

Obviously, we find that science and innovation evolve rapidly, and that working groups don't necessarily move at the same pace. In our opinion, it's important to take into account cutting-edge work and all the research being done. Things are moving much faster these days, so we find it somewhat unfortunate that we're always looking to the past rather than keeping up with what's being done now.

Since we know that there are several types of breast cancer, and that breast cancer affects different communities, different age groups and women with different realities, it would be important for specialists from all the relevant fields to sit on these committees. They should be much more inclusive and forward-looking.

[Dominique Vien, Conservative, Bellechasse—Les Etchemins—Lévis, QC]

Dr. Appavoo, I heard your comments about the task force loud and clear. You're saying that things aren't moving in the right direction and that you're watching.

Can you remind us how many women sit on that task force?

[The Chair, Conservative, Shelby Kramp-Neuman]

You can answer that quickly.

[Dominique Vien, Conservative, Bellechasse—Les Etchemins—Lévis, QC]

Perhaps our analysts can provide us with those numbers; however, since I had 15 seconds remaining, I wanted to ask the question. Thank you.

[The Chair, Conservative, Shelby Kramp-Neuman]

If you could send along a response, that would be ideal. You could submit it to the committee.

[Dr. Shiela Appavoo]

Are you asking me?

[The Chair, Conservative, Shelby Kramp-Neuman]

Yes, if that's possible. If you have any questions, you can follow up with the committee afterwards.

[Dr. Shiela Appavoo]

Was I being asked how many women were on the task force? Okay. Yes, I can look that up and tell you.

The working group for the breast cancer screening guideline was chaired by a woman.

[The Chair, Conservative, Shelby Kramp-Neuman]

Okay. Thank you very much.

Only because of the shortness of time, we will move on to our next member of Parliament to pose questions.

You have five minutes, Marc.

[Marc Serré, Liberal, Nickel Belt, ON]

Thank you, Madam Chair.

I want to thank all the witnesses, who presented us with some excellent recommendations on breast cancer screening. For example, they told us that screening should start at age 40, and earlier for women at risk. We also heard recommendations for women of colour, indigenous women and women with special needs. Some never even get the chance to have a mammogram.

Then, we were told that more data is needed. Dr. Gordon said that data already exists, but that the Task Force on Preventive Health Care wasn't even consulting that data. I hope, then, that the task force and the Public Health Agency will listen to today's testimony and recommendations.

I think it's appalling, what the task force has done.

Dr. Gordon, you mentioned completely dismantling the task force, so my first question will be for you.

Dr. Appavoo, you mentioned a moratorium on the task force guidelines and recommendations, so I would like to hear from both of you. If that happens, what is a replacement? What are the next steps if we dismantle the task force or put in place a moratorium?

I'll have Dr. Gordon answer first and then Dr. Appavoo, please.

[Dr. Paula Gordon]

I would like to point out to the committee that the task force was disbanded by the Liberal government in 2005 and reinstituted in 2010 but with no oversight, so, yes, it can be suspended. In the meantime, there are provincial guidelines that can be followed, but they need to be publicized, and women need to know that they can self-refer.

[Marc Serré, Liberal, Nickel Belt, ON]

Shiela.