Status of Women Committee on Nov. 18th, 2024

[Dr. Guylène Thériault]

Madam Chair, this gives me the opportunity to talk about all that we're planning to do to ensure that our recommendations can be implemented and reach as many women as possible.

We have the guidelines. We have the 1,000-person tool that can foster discussion with a primary care provider. We had, in the past, a real, shared decision-making tool that we're looking into implementing. We are looking into creating videos and also an interactive tool online for women so that they can access the information in absolute numbers in a transparent way that applies to them and be empowered to make a decision that aligns with their values and preferences.

[The Chair, Conservative, Shelby Kramp-Neuman]

Thank you very much.

Andréanne, you have the floor for two and a half minutes.

[Andréanne Larouche, Bloc, Shefford, QC]

Thank you, Madam Chair.

Ladies, did you receive the letter sent by the committee in July, containing four observations related to the recommendations?

The first observation is that the task force should lower the recommended age in the Canadian breast cancer screening guidelines for those at average risk for—

[Pam Damoff, Liberal, Oakville North—Burlington, ON]

On a point of order, I'm not getting any translation, Chair.

[The Chair, Conservative, Shelby Kramp-Neuman]

Okay, we'll pause your time for a minute, Andréanne.

Dr. Reynolds, I see that you're not getting any translation either.

We'll just suspend for a quick minute while we work out the translation.

[The Chair, Conservative, Shelby Kramp-Neuman]

We will resume as before.

Andréanne, you still have two minutes left.

[Andréanne Larouche, Bloc, Shefford, QC]

I was saying that the first observation was that the task force should lower the recommended age in the Canadian breast cancer screening guidelines—

[Anna Roberts, Conservative, King—Vaughan, ON]

I'm not getting any translation.

[La présidente, Conservative, Shelby Kramp-Neuman]

Is it coming across in French?

[An hon. member]

Yes.

[The Chair, Conservative, Shelby Kramp-Neuman]

Okay.

Andréanne, could you please...?

[Andréanne Larouche, Bloc, Shefford, QC]

Are you asking me to do a test?

I will check, but I find it peculiar that I can't finish my remarks just as I'm getting to my question.

I don't speak that quickly, but I'll keep going.

[The Chair, Conservative, Shelby Kramp-Neuman]

Okay. That's perfect.

[Andréanne Larouche, Bloc, Shefford, QC]

Madam Chair, I'm wasting time and I'm being penalized by having to repeat what I've already said.

May I have my two and a half minutes back, please?

[The Chair, Conservative, Shelby Kramp-Neuman]

Yes.

[Andréanne Larouche, Bloc, Shefford, QC]

Thank you.

I will therefore ask the representatives of the Canadian Task Force on Preventive Health Care whether they did indeed receive the letter that the Standing Committee on the Status of Women, or FEWO, sent them in July. It contained four observations, which I will now reread.

Observation 1 The Task Force should adjust the recommended breast cancer screening age for individuals of average risk to include 40 to 49 year olds in Canadian guidelines, to reflect the latest evidence and specialized expert opinion.

Observation 2 The Task Force should consider the testimony received during FEWO’s meeting on June 11, 2024, and undertake a full review of all other recommendations contained in the Breast Cancer (Update)—Draft Recommendations (2024) to ensure that these are inclusive, informed by relevant feedback from the public comment process, by the most recent research and evidence, and reflect modern medical technology and treatment advances.

Observation 3 The Task Force should ensure that the process of public comment on the Breast Cancer (Update)—Draft Recommendations (2024) is transparent and the results of this process are made public to facilitate accountability.

Observation 4 The Task Force should amend the Breast Cancer (Update)—Draft Recommendations (2024) to ensure that women with dense breasts receive annual mammograms and are offered additional MRI or ultrasound screening.

What do you have to say about that letter and the four recommendations we sent you?

[Dr. Guylène Thériault]

Madam Chair, thank you.

I can tell you quickly that we responded to that letter in detail. You can find more explicit answers in it than what I can provide in a short time.

We looked at the most recent data. Our systematic review goes back to the summer of 2023. All the most recent observational data, including data from the major Canadian study you heard about, are therefore included.

[Andréanne Larouche, Bloc, Shefford, QC]

It is true that you responded to that letter, but understand that what we've been hearing since we resumed this study is not in line with what was recommended by the experts and witnesses we heard from. That is why we sent you this letter last July.

I don't think your answer takes into account what we've been hearing since then.

[Dr. Guylène Thériault]

Madam Chair, I don't know if I should say anything to this. Is that a question?

[The Chair, Conservative, Shelby Kramp-Neuman]

At this point, I'll pass the floor to MP Gazan.

You have the floor for two and a half minutes.

[Leah Gazan, NDP, Winnipeg Centre, MB]

Thank you so much, Madam Chair.

I want to go back to what I was talking about in terms of samples, because I know you based it on other research, and all research is based on samples.

I'm going to read another quote by Dr. McKerlie. It was in the letter we sent.

She said that not only were the studies that were prioritized during the development of the draft recommendations out of date, but they also used a sample population composed of 98% white women. That means you would have known.... I would assume that if you were looking at research, you would want to know what the sample in your research was.

I want to go back to something you said about what you found with Black and indigenous women, which was that only Filipina women had higher rates. How can you state that finding, when only 2% of the sample in the data collected were non-Caucasian women?

Don't you agree with me that's too small a sample size to base an overall recommendation on for screening?

[Dr. Guylène Thériault]

There are two questions in there.

One of them is that we prioritized studies that were out of date. We had a comprehensive review. We looked at studies that were old but also very recent observations as well—

[Leah Gazan, NDP, Winnipeg Centre, MB]

I'm asking about the sample.

Were you aware that 98% of the sample you were looking at in the research and the data collected were Caucasian women?

[Dr. Guylène Thériault]

Madam Chair, I think I answered that question before.

About the Filipina reference, I just want to make sure that we're well understood today. The data that I gave was not just Filipina but Arab, Filipina and multi-ethnic. It's not from the study—

[Leah Gazan, NDP, Winnipeg Centre, MB]

How much of the sample...? I'm sorry, but I don't have a lot of time.

All the expert witnesses who have come here have indicated that 98% of your sample size were Caucasian women. That means 2% were “other” in the data collected, the sample on which you based your recommendation. This is deeply troubling—