Quebec banning mammograms for women in their 40s — and why this may not be enough

Quebec’s ban on mammography for women in their 40s has been criticized by other provinces as being discriminatory. A study published Friday in The Canadian Medical Association Journal (CMAJ) claims there are other reasons for this disparity.

Researchers from the hospitals Maisonneuve-Rosemont Hospital and Jewish General Hospital compared “standardized female cancer screening experiences,” including a mammogram in the 35 and under group, in comparison to the past 8 years of younger-looking women. They found that “the long term impact of a mammogram at age 35 had not increased” over the previous eight years, despite an increase in the 40 to 49 age group, followed by women aged 50 to 59 and then women aged 60 to 69.

They also found a difference between hospital patients — 41 percent were screened from age 35 to 39 years old, whereas 22 percent were screened from age 40 to 49 years old. Meanwhile, just 16 percent of women in the 35 to 39 age group were screened after the age of 50. However, for the young women in the older group, “screening practices after age 50 were similar to earlier generations.”

The authors of the paper are perplexed by the policy, suggesting they are “driven in part by weak evidence and possibly biases.” In particular, the researchers note that even though breast cancer screening is associated with improving early-stage survival, it’s just not tied to leading to death rates. But, “when screening recommendations are overly rosy, studies become more and more controversial,” they warn.

They are critical of Quebec’s policy, which they argue is based off a Canadian study that proves the decreased survival rates for young women screened later are in favor of the older women who had earlier scans. This study, which the authors say is flawed, was reported to include evidence from almost 80 other countries — but just five.

Nevertheless, the authors emphasize the importance of breast screening. According to the CMAJ authors, the measures to better screen for breast cancer “should be studied carefully and considered carefully.”

Read the full story at The Canadian Medical Association Journal.

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