Breast Cancer Awareness Mnth 2018 Key Messages (as f June 6, 2018) In this dcument there are tw sectins f messages in supprt f Cancer Care Ontari s Breast Cancer Awareness Mnth 2018: 1. Campaign key messages 2. Call-t-Actin 1. Campaign Key Messages with Supprting Pints Octber is Breast Cancer Awareness Mnth and Cancer Care Ontari is encuraging wmen ages 50-54 t talk t their healthcare prviders abut getting screened with a mammgram. In 2015 2016, the lwest participatin rate was amng wmen ages 70 74 (59.1 percent), fllwed by wmen ages 50 54 (62.1 percent). 1 Amng wmen wh had a mammgram thrugh the Ontari Breast Screening Prgram (OBSP) in 2014, retentin (wmen receiving their next scheduled screening n time) was highest in thse ages 65 t 69 (82 percent) and lwest in thse ages 50 t 54 (74 percent). 2 A similar pattern was seen in previus years. Breast cancer is the mst cmmn cancer in Ontari wmen. One in eight wmen will be diagnsed with breast cancer in her lifetime. 3 It is estimated that abut 11,762 Ontari wmen will be diagnsed with breast cancer and abut 1,977 wmen will die f the disease in 2018. 4 In Ontari, breast cancer happens mstly in wmen ages 50 t 74 (61 percent f cases). 5,6 1 Cancer Quality Cuncil f Ontari. Cancer System Quality Index 2018. Trnt, ON: Cancer Quality Cuncil f Ontari. 2 Cancer Quality Cuncil f Ontari. Cancer System Quality Index 2018. Trnt, ON: Cancer Quality Cuncil f Ontari. 3 Cancer Care Ontari. Ontari Cancer Statistics 2016. Trnt, ON: Cancer Care Ontari; 2016. 4 Cancer Care Ontari. Ontari Cancer Statistics 2018. Trnt, ON: Cancer Care Ontari; 2018 5 Cancer Care Ontari. Ontari Cancer Statistics 2018. Trnt, ON: Cancer Care Ontari; 2018. 1
Breast cancer has ne f the highest survival rates f all cancer types in Ontari. 7,8 Regular breast cancer screening is imprtant because it can find cancer early when it may be smaller and easier t treat. Deaths frm breast cancer in the Ontari ppulatin went dwn by abut 47 percent in wmen ages 50 t 74 frm 1990 t 2013. 9 This decrease in deaths is prbably due t imprvements in breast cancer treatment and mre wmen getting screened with mammgrams. 10 Imprtance f Breast Cancer Screening Studies shw that regular mammgrams (and prper fllw up testing fr abnrmal results) lwer the risk f dying frm breast cancer in wmen ages 50 t 74. 11 In wmen ages 50 t 69, ne death is prevented fr every 721 wmen wh get screened regularly with mammgrams ver a perid f time (apprximately 11 years). 12 In wmen ages 70 t 74, ne death is prevented fr every 451 wmen wh get screened regularly with mammgrams. 13 The OBSP recmmends that mst wmen ages 50 t 74 get screened every tw years with mammgraphy. Regular breast cancer screening is imprtant because it can find breast cancers when they are small, less likely t have spread and mre likely t be treated successfully. Amng Ontari wmen wh had a mammgram thrugh the OBSP in 2014, 79 percent returned within 30 mnths fr anther mammgram, which is a decrease frm the 81 percent wh returned in 2013; retentin was lwest in wmen ages 50 t 54 (74 percent). 14 This means there are still many eligible wmen wh culd benefit frm regular breast cancer screening. 6 Surveillance, Analytics and Infrmatics, 2018. [Unpublished internal dcument], Cancer Care Ontari. 7 Cancer Care Ontari. Ontari Cancer Statistics 2018. Trnt, ON: Cancer Care Ontari; 2018. 8 Cancer Quality Cuncil f Ontari. Cancer System Quality Index (CSQI) 2018. Trnt, ON: Cancer Quality Cuncil f Ontari. 9 Surveillance, Preventin and Cancer Cntrl. 2018 April 2. [Unpublished internal dcument], Cancer Care Ontari. 10 Cancer Care Ontari. Ontari Breast Screening Prgram (OBSP) Infrmatin fr Healthcare Prviders. Trnt, ON; 2015 Oct. 11 The Canadian Task Frce n Preventive Health Care. Recmmendatins n screening fr breast cancer in average risk wmen aged 40-74 years. CMAJ. 2011; 183(17):1991-2001. 12 The Canadian Task Frce n Preventive Health Care. Recmmendatins n screening fr breast cancer in average risk wmen aged 40-74 years. CMAJ. 2011; 183(17):1991-2001. 13 The Canadian Task Frce n Preventive Health Care. Recmmendatins n screening fr breast cancer in average risk wmen aged 40-74 years. CMAJ. 2011; 183(17):1991-2001. 14 Cancer Quality Cuncil f Ontari. Cancer System Quality Index 2018. Trnt, ON: Cancer Quality Cuncil f Ontari. 2
Mammgrams are nt perfect tests. Talk t yur healthcare prvider abut the benefits and limitatins f breast screening. Mammgraphy may miss sme breast cancers. Sme cancers develp in the time between screens. Mammgram results are smetimes abnrmal when mre tests (e.g., bipsies) shw that there is n cancer present. This is called a false-psitive result. Sme breast cancers that are diagnsed thrugh screening may never cause symptms in a wman during her lifetime (i.e., ver-diagnsis). Therefre, sme wmen may have surgery r treatment fr a breast cancer that wuld nt have becme life-threatening. Nt all cancers fund by screening can be treated successfully. Abut the Ontari Breast Screening Prgram The Ontari Breast Screening Prgram (OBSP) is a prvince-wide rganized screening prgram that aims t reduce breast cancer mrtality thrugh regular screening. Organized cancer screening prgrams are run centrally, and use clear, cnsistent plicies and prcesses. An rganized screening prgram will use scientific evidence t determine which grups f peple are at risk f getting certain cancers, and hw ften they shuld get screened. Organized screening prgrams track and measure their wn quality and perfrmance t mnitr hw they are ding and help them make recmmendatins fr imprvement. The OBSP prvides high-quality breast screening thrughut Ontari t tw grups f wmen, and recmmends that: Mst wmen ages 50 t 74 get screened every tw years with mammgraphy. Wmen ages 30 t 69 wh are cnfirmed t be at high risk f getting breast cancer get screened nce a year with a mammgram and breast magnetic resnance imaging (MRI) (r screening breast ultrasund if MRI is nt medically apprpriate). As f April 2018, the OBSP prvides services thrugh 225 breast screening sites, including tw mbile screening caches (buses in nrthwestern Ontari and Hamiltn with mammgram machines n bard) and f these, 30 are High Risk OBSP sites. Seventy sites are als OBSP breast assessment sites that crdinate fllw-up tests and help guide wmen with abnrmal screening results thrugh the diagnstic prcess. 15 15 Prgram Operatins, Cancer Screening, Preventin and Cancer Cntrl. 2018 April 1. 3
Frm the start f the prgram in 1990 t July 2017, ver 1.9 millin wmen ages 50 t 74 had a mammgram thrugh the OBSP, resulting in mre than 7.4 millin mammgrams cmpleted. Mre than 39,000 breast cancers were fund thrugh the OBSP, mst f which were in early stages. 16 Fr every 200 wmen screened in the OBSP, abut 18 are sent fr mre tests and ne will have breast cancer. 17 All OBSP sites are accredited by the Canadian Assciatin f Radilgists Mammgraphy Accreditatin Prgram (CAR MAP). The High Risk OBSP sites help wmen wh may be at high risk f getting breast cancer t underg a genetic assessment. Fr wmen wh have been cnfirmed t be at high risk f getting breast cancer, High Risk OBSP sites ffer yearly screening mammgrams and screening breast MRI (r screening breast ultrasund if MRI is nt medically apprpriate). Fr wmen with abnrmal screening results, the High Risk OBSP sites crdinate fllw-up breast assessments (i.e., any additinal tests they need). In 2014, 5,542 wmen were screened in the High Risk OBSP. Of these wmen, 1,277 had an abnrmal result and 70 breast cancers were fund which is a cancer detectin rate f 12.7 fr every 1,000 wmen screened. 18 Wmen Wh Qualify fr OBSP Screening The OBSP screens tw grups f wmen: Ontari wmen ages 50 t 74 wh have: n acute breast symptms; n persnal histry f breast cancer; n current breast implants; nt had a mastectmy; and n histry f a screening mammgram within the last 11 mnths. Wmen ver age 74 can be screened thrugh the OBSP; hwever, they are encuraged t make a persnal decisin abut breast cancer screening after speaking with their healthcare prvider. These wmen will need a referral frm their healthcare prvider t get a mammgram. The OBSP will nt send letters t wmen ver age 74 reminding them t cntinue participating in the prgram. There is n high-quality scientific evidence t supprt rutinely screening wmen ver age 74 with mammgraphy. 16 Analytics, Cancer Screening, Preventin and Cancer Cntrl. 2018 May 7. [Unpublished internal dcument], Cancer Care Ontari. 17 Estimates prvided by Cancer Care Ontari, Preventin and Cancer Cntrl (Evaluatin and Reprting); data surce Integrated Client Management System, 2018. 18 Cancer Care Ontari. Ontari Cancer Screening Perfrmance Reprt 2016. Trnt, ON: Cancer Care Ontari; 2016. 4
Ontari wmen ages 30 t 69 can get screened thrugh the High Risk OBSP if they have a referral frm their dctr, have n acute breast symptms and fall int ne f the fllwing risk categries: are knwn t have a gene mutatin that increases their risk fr breast cancer (e.g., BRCA1, BRCA2, TP53, PTEN, CDH1); are first-degree relatives f smene wh has a gene mutatin that increases their risk fr breast cancer (e.g., BRCA1, BRCA2, TP53, PTEN, CDH1), have already had genetic cunselling and have chsen nt t have genetic testing; have been assessed at a genetic clinic (using the IBIS r BOADICEA tls) as having a 25 percent lifetime risk f breast cancer based n persnal and family histry; r have had radiatin therapy t the chest t treat anther cancer r cnditin (e.g., Hdgkin lymphma) befre age 30 and at least eight years ag. Fr these wmen, screening wuld nt start befre age 30. Fr example, a wman wh is 35 and had radiatin at age 29 wuld be eligible fr the High Risk OBSP when she is 37. A wman wh is 26 and had radiatin at age 18 wuld be eligible at age 30. A wman wh is 40 and had radiatin at age 31 is nt eligible. Less than ne percent f wmen in the general ppulatin are estimated t be at high risk f getting breast cancer. 192021 Wmen at high risk have a greater estimated lifetime risk f develping breast cancer (up t 85 percent) than the general ppulatin (10 percent t 12 percent). 20 2. Call-t-Actin Talk with yur healthcare prvider tday abut yur breast screening ptins. T learn mre, visit www.cancercarentari.ca/bcam. Nte: Belw is a list f shrt, snappy call-t-actins fr cnsideratin fr creative prducts (pstcard, pster, rll-up banner) Over 50? Ask yur healthcare prvider abut regular breast cancer screening. Learn the facts abut getting screened fr breast cancer. 19 Blackhuse G, Geree R. Budget Impact Analysis fr Magnetic Resnance Imaging Screening f Wmen at High Risk fr Breast Cancer in Ontari. Prgram fr Assessment f Technlgy in Health (PATH). 2007 May 8. 20 Warner E, Messersmith H, Causer P, Eisen A, Shumak R, Plewes D. Magnetic resnance imaging screening f wmen at high risk fr breast cancer: a clinical practice guideline. Prgram in Evidence-Based Care. 2007 Apr 12. 5
Learn abut yur ptins fr getting screened fr breast cancer. Mark yur calendar t talk with yur healthcare prvider abut breast screening. 6