Recommendations on screening for breast cancer in women aged 40–74 years who are not at increased risk for breast cancer

Canadian Task Force on Preventive Health Care

Breast cancer mortality rates among Canadian women have declined from 41.7 per 100 000 in 1988 to an estimated 23.2 per 100 000 in 2017, while age-standardized incidence has remained relatively stable, at around 130 per 100 000 since 2004. Declining mortality with stable incidence could reflect improvements in breast cancer treatment, timely detection of symptomatic cancer, screening programs, or all of these. Breast cancer screening programs have been in place in most regions of Canada since the early 1990s. In 2014, 54% of women aged 50 to 69 years had been screened in the previous 30 months via a screening program, and an unknown number of women were screened outside of programs. Screening may identify breast cancer earlier and lead to more effective and less invasive treatment; however, it may also lead to overdiagnosis and subsequent treatment of cancer that, left untreated, would not have become apparent or caused harm. Examples of adverse sequelae of treatments (e.g., surgical intervention, radiotherapy, chemotherapy) include pain, disfigurement and distress. In addition, false-positive screening results may have a psychological impact and can lead to adverse physical effects from further testing.

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