Mr. Speaker, it is with great humility, sensitivity and heartfelt thoughts for all those who have lost a loved one to breast cancer that I rise today to speak to this report of the Standing Committee on Health. What is unusual is that the report is not even finished, even though the committee began drafting it last spring. I am deeply humbled to speak this evening because I have some big shoes to fill. That is because I am filling in for my colleague from Montcalm, who is an excellent health critic and one of the co-chairs of the Standing Committee on Health, which examined this issue. I will try my best to do him justice.
This report addresses the crucial and important issue of national breast cancer screening standards. Although the report has yet to be completed, there seems to be some consensus that the screening age should be lowered to 40. Study after study and report after report have confirmed it. My colleague, the health critic and member for Montcalm, has given me his seat on the Standing Committee on Health for the women's health study. In addition, the Standing Committee on the Status of Women also began a supplementary study focusing more specifically on breast cancer screening standards at age 40. We are starting to hear a lot of testimony about lowering the screening age from 50 to 40. After my speech, I have to go back to the Standing Committee on the Status of Women for instructions for the report on that topic.
I will begin by summing up the issue of standards for screening at age 40. I will then talk about other recommendations on women's health. I will close by highlighting the importance of health care transfers for giving the health care system more resources. Towards the end of my speech, I am going to broaden the debate a little.
I will begin with a little background information. The Canadian Task Force on Preventive Health Care recommended screening at age 50 as a national standard. People started speaking out to explain that the global trend was more in favour of starting screening at age 40. The Standing Committee on Health heard this perspective during a study on women's health. It then undertook a study specifically focusing on standards for breast cancer screening starting at age 40. As I said earlier, a short time later, the Standing Committee on the Status of Women decided to draft its own report on the age 40 standards. At first, we planned to meet twice, but more meeting hours and more witnesses were subsequently added. That is why we still do not have the report in hand.
Expert testimonies are more or less unanimous. In contrast, the members of the Canadian Task Force on Preventive Health Care are having a hard time explaining their position. A few lines have been put forward. There are more and more studies demonstrating the importance of prevention when it comes to breast cancer. There are also more and more international examples and figures showing that it costs less to treat cancers that are caught at a less aggressive stage. Then there is also the fact that early detection increases the chances of survival and reduces the impact on quality of life. If we lower the screening age to 40, however, the federal government will have to make a contribution, give the means and provide the health transfers. I will come back to that later. I should point out that this could result in savings. More than $460 million could be saved with early protection and screening. Investing in screening is a good thing. It is in no way an expense.
We also learned that many experts had tried to contact the task force with their comments. However, they were reportedly ignored. Non-disclosure agreements were even signed to silence witnesses. Questions are being asked about the composition of this group. Survivors came forward to explain that their perspective was non-existent in this task force.
It was also found that some communities were disproportionately and differently affected by breast cancer. This includes Black communities and indigenous communities. There was even a lot of talk about the issue of women from the Philippines. There are different points of view that were not taken into account by the task force.
Women must certainly not be prevented from asking to be tested before age 50, the age currently recommended by the task force. That is more or less what we were told. We have some international examples. That was an important starting point for our reflection process and the start of this study. There are international studies, for example in the United States, that show the importance of making this shift. In April, the United States Preventive Services Task Force published an update on its 2016 recommendation.
That update reads as follows: “Previously, we recommended that women in their 40s make an individual decision with their clinician on when they should start screening, taking into account their health history, preferences, and how they value the different potential benefits and harms. The Task Force now recommends that all women start getting screened for breast cancer every other year starting at age 40. Basically, it’s a shift from recommending women start screening between the ages of 40 and 50 to recommending that all women start getting screened when they turn 40.” That is what it says on the website of the U.S. task force.
Even here in Canada, women in British Columbia and Yukon can start asking for mammograms at age 40. Nova Scotia and Prince Edward Island offer annual mammogram screening for women who are asymptomatic. In Ontario, the age of eligibility for publicly funded mammograms changed from 50 to 40 in October. This shows that the trend toward starting screening at age 40 is becoming increasingly widespread.
Even in Quebec, the minister of health, Christian Dubé, recently commissioned a task force to study the possibility of lowering the age of preventive screening to age 40. The findings could not be clearer. After instructing the Institut national d'excellence en santé et en services sociaux, or INESSS, to assess the possibility of expanding breast cancer screening to start at age 40, Quebec's health minister, Christian Dubé, says that the cost is worth it. It is therefore hard to understand why the Canadian task force is digging in its heels.
In addition, the Canadian Cancer Society issued a press release in May urging the provinces and territories to lower the eligibility age for breast screening programs to 40 for individuals at an average risk of developing breast cancer. This recommendation has been made by Quebec, the provinces, other countries and even organizations.
Second, I would like to come back to a study that the Standing Committee on Health is currently conducting on women's health. If everything goes smoothly, the committee will begin studying the report tomorrow. Several different topics have been discussed. The gender health gap exists and has been proven. One of the issues is medical bias.
Yesterday, I met with representatives of a brand new clinic that opened this year. This clinic seeks to be more inclusive and to offer services to women in the LGBTQ community who have difficulty finding their place in the health care system and who experience medical bias. I met representatives of this clinic at the recent Emergence Gala. Yesterday, we talked for over an hour and they did a great job of explaining this reality to me, including the fact that women do not always feel that they have a place in the health care system. They do not always feel as though they are being listened to in the current health care system. They are discriminated against. The clinic I am talking about is Vivago, an inclusive health care clinic. We really had a great discussion. We promised to do it again and to stay in touch so that we can continue to share information.
During this study, we also examined the issue of endometriosis and other gynecological problems. As we have heard, for a long time, endometriosis was just seen as a problem experienced by women who were not strong enough to endure the pain. For a long time, there was persistent bias regarding this condition. Proper investments were not made in research because endometriosis was considered a woman's problem that was not important.
Obviously, in the recommendations, we hope that there will be more research on this front.
It is the same for cancer. There is breast cancer screening for women. As I was saying, we examined this issue because the study on women's health came before the study on the rules around screening at age 40. The question of gynecological cancers is an interesting one. Cervical cancer is rare, but we now have a vaccine that can prevent it. The World Health Organization believes in it strongly, and Canada has set targets. When we heard from the experts during the study, they made it clear that we are missing the target. However, vaccine procurement is the federal government's responsibility. Quebec and the provinces are responsible for health administration, but health transfers and procurement are the federal government's responsibility. There are some things that the government could be doing.
Another issue is women's mental health. How long were women treated as hysterical? Postpartum depression was observed in women, but it was trivialized for a long time, despite increasing evidence that it was real. During the study on women's health, the committee also heard that it has an impact not only on the mother, but also on the children and the entire family. People used to think it was because she had just given birth and that she would recover. Now we are starting to take postpartum depression more seriously and treating it as a real condition, not just as the whim of a woman who is too weak psychologically to cope with the presence of a new child after giving birth. Could more research be done to find better ways to help and support women when they are going through what should be one of the best experiences of their lives, and to support them through it all?
In the end, the study was quite broad. I look forward to seeing what happens next. There were instructions for the report, but now we are beginning to study the report, and we will see what recommendations are made in the coming weeks and months.
Third, this is, of course, going to take resources. That is why I am going to end my speech by talking about health transfers. For example, in Quebec, the government's challenge is to expand access to mammography to women aged 40 to 74. That involves guaranteeing reasonable wait times in all regions of Quebec. As the study on women's health showed, there are still too many women who do not have access to the same services because of where they live. The services offered in rural areas are not the same. How can we ensure that wait times are the same in every region of Quebec?
Quebec's health minister calculated that, if women in their forties were included in routine screening, it would require 100,000 to 150,000 more mammograms a year. That will cost money, but it should not be a reason not to move forward and work on the issue of screening. So many survivors told the committee how important prevention is. I spoke about savings earlier, but the treatment is not the same for stage 1, stage 2 or stage 4 cancer. The effects on the body and the long-term impacts are not the same.
It is important to take all of that into consideration and not just decide that we cannot afford to implement this recommendation. We have to find a way. As I said earlier, the government has been reducing its investments for a long time. Remember that initially, the federal government's share of the transfers was 50%. This is one budget item that must not be cut in the name of austerity. On the contrary, it should be increased. Quebec and the provinces have unanimously called for a 35% contribution. It is currently barely reaching 20%. That is not enough. I think we can and must do better at making sure we can offer mammograms starting at age 40. That is why the federal government must respond to this request and plan for better transfers for the future than what it is offering right now.
In closing, I also want to say that I asked the witnesses questions in committee because more and more young women in their thirties and forties are dealing with aggressive forms of cancer. The issue has come up a lot lately. For example, there was the high-profile case of entrepreneur Geneviève Everell, who shared her story. During her second pregnancy, she was diagnosed with cancer that needed to be treated soon. For the time being, she is doing well. She gave interviews and explained what she was going through. She found out in the middle of her pregnancy that she was going to have to deliver her baby after she started cancer treatment. Evidently, it is no illusion; these cancers really are affecting younger and younger women more and more aggressively. This has an impact on the whole family and everyone around them. Truly, Geneviève Everell, whom I do not know personally—