Mr. Speaker, I move that the 20th report of the Standing Committee on Health, presented on Wednesday, June 19, be concurred in.
It is an honour to speak this afternoon. I will split my time with my great colleague and friend, the member for Peterborough—Kawartha.
It is with great sadness, though, that I have to rise in the House today to speak to the report from the health committee related to breast cancer screening guidelines in Canada. One of the things that we do know is that one in eight women will be diagnosed with breast cancer in their lifetimes, which is not an insignificant statistic. Even more poignant is that one in 36 are expected to die from the illness. When we look at these numbers, we know that this is something that, as we look around the chamber, could certainly affect many of us who are here.
From a very personal perspective, I want to say that my own wife, Deborah, had breast cancer and now, as of this spring, will be an eight-year survivor. Again, not to be overly personal, but when somebody realizes they have cancer, either by screening mammography or because they have found a lump in their breast, as a spouse who has experienced it and as a former physician who has seen this happen many times, the whole world comes to a screeching halt.
The most difficult thing, of course, is not knowing what is next, not knowing how severe the illness is and not knowing exactly what the treatment is going to look like, how they are going to feel, how long it is going to last or how terribly it is going to affect them, their family and those who are there to support them. Sadly, it also presents a significant financial burden often for Canadians who live in rural communities and have to go back and forth to appointments in larger centres at their own expense. That is not an insignificant thought either. Taking time off from work further exacerbates that difficulty. Certainly, I am thankful every day that my wife has made the incredible recovery that she has.
From a statistical perspective, breast cancer is also the most commonly diagnosed cancer in Canadians aged 30 to 49, which really brings us to look at why it is so important that the current guidelines, which suggest that Canadian women should begin screening for breast cancer via mammography at age 50, should be reduced and screening offered to women at the age of 40.
It really does pain me to think that this is a political issue. The difficulty is that those who bring forward the science around this, sadly, are not being listened to. It is the Canadian Task Force on Preventive Health Care that puts forward these guidelines. It does not mean that the guidelines are binding to physicians, but certainly many jurisdictions would use those recommendations from the Canadian task force to inform decisions related to offering mammography to women earlier.
Part of the discussion is absolutely abhorrent when we begin to consider it. Some of the testimony that we heard was that screening women earlier would lead to finding things that would have to be investigated and, in the end, would turn out not to be cancerous, and of course that creates some anxiety. There were actually witnesses who suggested that the anxiety would be overwhelming. From the perspective of someone who has gone through it in a few different ways, it would be much more anxiety producing to miss something and know that someone had a much further-advanced cancer than they would have if it had been caught earlier.
As we look at some of the statistics around this, there was a study published that looked at this particular issue and said Canadian women 40 to 49 years old were diagnosed with significantly fewer stage 1 and more stage 2 and stage 3 breast cancers than women aged 50 to 59. That means that, because younger women were not being offered screening mammography, their cancers were diagnosed at a much more advanced stage. As many people here in the House and watching on TV would know, when cancers are diagnosed at a later stage, the person is given a much worse prognosis or outcome and that is certainly something that we want to avoid in cancers.
Those cancers that are diagnosed at an earlier stage are more easily treatable, and the outcomes are significantly more favourable. We also know that the five-year survival rate is 74% for stage 3 breast cancer and only 23.2% for women who have stage 4 cancer. That is just to support the notion that the earlier the stage at which breast cancer and other cancers are found, the more favourable the outcomes are.
It is also interesting, when we begin to look at this, that this same study we are talking about found that earlier screening led to significantly improved survival rates among women in their forties with breast cancer who lived in provinces where they were allowed to receive screening in their forties. Once again, we see this new evidence that is out there.
Part of the difficulty with the task force is that it only wants to accept randomized, placebo-controlled, double-blind trials. What does all of that scientific gobbledygook mean? That means that one group would have a treatment and the other group would have a sham treatment, and then we would compare the outcomes without either group knowing which one they were in. That would be unethical to do, because we know at the current time that screening for breast cancer is a proven treatment.
What we need to understand now is that the outdated information, often from the 1960s, does not necessarily apply to the significant advancements in imaging that we now have in the 2020s. Because that new information is not being included in the decision-making process, what we are finding is that the folks on the preventive task force do not want to change the guidelines in spite of the fact that there is overwhelming evidence to do the contrary.
I think it also important to outline to Canadians that this is about women in the 40- to 49-year age category, and there is also an interesting scientific notion of “potential years of life lost”. For instance, if a 45-year-old woman dies at age 45 and would have lived to 85, that is 40 years of potential years of life lost. We also know that many women are, as is anybody in society at age 40 to 49, in the heyday of their working careers. They are wives. They are mothers. They are sisters. They are daughters. They are aunts. As we look at that significant portion of the life that is lost, we know that in Canada things can be better than that.
Dr. Paula Gordon, a clinical professor at UBC, informed members of the health committee in June of this year that “women aged 40 to 49 are 44% less likely to die of breast cancer if they have mammograms.” We also heard that breast cancer in younger women is often “more aggressive” than that in older women and spreads faster if left untreated.
There are a couple of other notions that need to be brought forward here. It has also been reported that the peak incidence of breast cancer for Black and Asian women is 10 years earlier than among white women, and racialized minorities are particularly harmed by the current outdated guidelines. We also know that, in the United States, the United States Preventive Services Task Force recommended last year that women begin receiving mammograms of a screening nature at age 40. Why we continue to use these outdated guidelines is very nonsensical.
There are about 470 women aged 40 to 49 who die of breast cancer each year. I think of how many lives we could save by changing these guidelines. I think that, on behalf of all Canadians, when new science becomes available, it is important that it gets called out, and we say that things need to change and they need to change rapidly.
On behalf of all Canadians, I would certainly say very strongly to the preventive task force that its guidelines need to change and they need to change quickly, because truly, in this instance, lives are at stake.
