Health committee  Thank you. The incidence change in Canada was different from the incidence in the United States. That may be one reason. Dr. Paula Gordon explained the difference in the two types of interval cancers. It's important to understand, exactly as Dr. Gordon said, that this is why screening doesn't help for some interval cancers.

Health committee  Thank you. It's important to note that a primary care provider can engage in shared decision-making with a woman without knowing the exact lifetime risk she has. That being said, it is important for a family doctor to assess a woman's risk factors—I agree with all the other experts here—because that primary care provider needs to know if that woman is even at an average risk.

Health committee  You won't anymore, not as of the fall of this year, fall 2024.

Health committee  I believe there are still two or three that require referrals, but that could be changed. It is not the mandate of the task force to control access to care.

Health committee  The task force's mandate is that women be informed. I'm sorry. Go ahead.

Health committee  Do you want me to answer, or is there no time?

Health committee  Thank you. All of the best available evidence on communication does suggest to communicate in absolute numbers. For example, there was a scare many years ago where we thought that the oral contraceptive pill doubled or increased the risk of a blood clot by 100%, but really, it took it from about one in 7,000 to two in 7,000.

Health committee  Just to clarify, if that family doctor followed the guidelines, they should refer for screening. Guideline care is to respect a woman's choice.

Health committee  The task force recommendations say that any woman who is 40 is eligible for a mammogram as long as she is informed, and they actually say that if she's informed and would like a mammogram starting at 40, she ought to have one. The task force does not control access. If across Canada we need to open up access, then the task force guidelines would be fine with that, as long as women are informed.

Health committee  Thank you. Just to clarify, the overall incidence of breast cancer in the Black community is less than average, but it does occur younger and the prognosis is poorer, as you said. I also want to reach out to Laila and say that I'm absolutely so sorry that this happened to you.

Health committee  Thank you for the opportunity to present to the committee today, and thank you for taking the time to review an issue so important to women's health. I'm a breast medical oncologist in Toronto. I speak with patients and their families about breast cancer every single day, and I see how this disease and its treatment impacts them.