Aaniin. Meegwetch. I'm joining you today from the traditional and unceded territory of the Lheidli T'enneh peoples, which is in Prince George, British Columbia, up in the north. I'm a surgeon and professor at the University of B.C., and I'm joining you today as an indigenous woman, daughter, mother, sister, auntie, cousin, and a member of the Sagamok Anishnawbek First Nation. I strongly recommend moving the breast cancer screening guidelines to commence at the age of 40, as opposed to the current recommendations set forth by the task force of 50.
I truly appreciate being here once again with my colleagues from the previous panel on November 18 so we can share more of our thoughts and ideally answer any questions you may have that cause you to either pause or not support this recommendation.
To remind you of what was said previously in November, there is a difference between the recommendation to participate in a screening mammogram program at the age of 50 and the option of a screening mammogram simply being available in your forties after discussion with a primary care provider, as in British Columbia. There is a paucity of data and research in this field, but there is data, and my colleagues have already shared some of it. Knowledge does exist that supports the need for earlier screening mammograms and for improving the rates of screening mammogram participation.
In British Columbia, we have a manuscript undergoing final review at the First Nations Health Authority that was completed in partnership with B.C. Cancer and the First Nations Health Authority chair in cancer and wellness. As I stated in November, when first nations women are compared to the rest of the women in B.C., their breast cancer is diagnosed at a later stage, as Angeline told us, and their survival rates are lower. These things could be addressed with screening mammograms by adjusting to this known data and moving to the age of 40.
The paucity of specific research regarding indigenous peoples and cancer is unto itself an entity that needs to be addressed, but I suspect that the persisting inequity in access to health research is beyond the scope of this meeting today. If we don't have data to support screening mammograms at the age of 50, why can we not start to err on the side of caution, unless you have firm proof that you will not be harming indigenous women by maintaining the recommendation that we are asking you not to maintain? There is some data to support screening mammograms at the age of 40 for indigenous women, given their later stages of diagnosis and poorer survival, but as a researcher in this field, I have seen no data to support screening mammograms for indigenous women at the age of 50.
Currently, it is recommended that screening mammograms start at the age of 50 unless you have known risk factors that increase your risk of breast cancer. This has also been referred to by my esteemed colleagues. You should start screening mammograms at the age of 40 if you have these risk factors. These risk factors can be related to family history or genetic test results that increase your risk, such as BRCA1 and BRCA2. Dr. Daniel described some amazing research she's doing to increase our knowledge of what risk factors can be.
These risk factors lead to being a barrier unto themselves for first nations women, because they have to have knowledge that they have these risk factors so their health care providers can subsequently recommend a screening mammogram at the age of 40. However, there is inequity in access to the knowledge of risk factors given that one's family history for breast cancer or genetic testing results for indigenous women can be greatly impacted by the legacy policies and programs in our country, whether regarding residential schools, the sixties scoop, forced relocation or inequitable access to medical genetics or hereditary cancer programs so you can know these genetic factors. I think there are also inequities upstream that block our ability to have a family doctor recommend that someone start at the age of 40.
In B.C., the recommendation is to start at 50, but it is available in your forties with your first step being to talk to your primary care provider. However, we know that access to primary care is in crisis in the health care systems in Canada, and this is worse when considering indigenous communities and challenges regarding access to primary care. Dr. Letendre was talking about this in more detail with respect to other barriers.
Finally, as an indigenous surgeon, I see women who have breast cancer, like a palpable mass. I see women who are referred due to an abnormal screening mammogram, and I see women who are already diagnosed with breast cancer. I have seen women who are devastated when the diagnosis is late and the outlook is bleak, and I have seen the relief when the results are reassuring, early-stage or negative.
Screening mammograms save lives. No one is denying that. Abnormal mammograms that turn out to be normal have been said to be stressful experiences. However, I think we need to start believing in the resiliency of women and give their voices back. We can handle the stressful experience of a test or tests that result in empowering results much easier than a diagnosis at a late stage of breast cancer that could have been completely prevented.
Chi-meegwetch. Thank you.