Breast cancer screening in Canada: 2021/2022

Strategies to improve breast screening for all eligible people

Ten provinces and one territory employ strategies to improve breast screening for all eligible people. Many use social media campaigns, presentations, and program material to increase awareness and education on breast screening. The use of client reminders and mobile screening clinics is a prevalent strategy to increase screening participation and access.

Strategies to improve breast screening for all eligible people

P/T Strategies used  Description of activities to improve breast screening for all eligible people
NT · Education
· Media (small and mass)
· Client reminder
· Recall system
· Patient navigation
· Healthcare provider cultural competency training
· Breast Cancer Screening awareness kits were developed and distributed to all community health centres
· Social media posts created and launched on the Northwest Territories Health and Social Services social media platforms (Twitter, Facebook, Instagram)
· Reminder letters mailed to patients
· Recall systems for patients in place
· 1:1 health education available with HCP’s in primary care clinics and community health centres
BC · Health care provider education
· Patient reminder letters
· Provider-to-patient letters for overdue patients
· Provider recall and result systems
· Annual provider report cards
· Traditional media
· Digital engagement and social media
· Website
· Suite of printed resources for patients and providers
· Translated and culturally relevant materials and resources
· Broad campaigns and awareness months
· Patient testimonial videos
· Animated patient education videos
· Advertising (Online, Radio, TV)
· BC Cancer Breast Screening employs a comprehensive approach to health promotion, including the engagement of health care providers in supporting patient education and navigation of screening pathway.
· The program provides screening information to patients in diverse ways, from printed resources to digital engagements, while considering their place in the screening journey, from initial awareness to long term participation in the program.
AB · Education (one on one and group)
· Client invitation and reminders
· Media (small and mass)
· Provider assessment and feedback
· Mobile screening clinics
· Healthcare provider cultural competency training
· Development of culturally safe materials and resources
· Program developed materials are in plain language.
· Share evidence and learnings with service providers to provide culturally safe care.
· Inclusive language in Standards and Guidelines.
· Work with our partners to provide consistent messaging to eligible people.
· Work with partners to provide providers with their annual panel reports on screening.
· Ongoing communication about screening through profession associations and colleges.
SK · Education
· Reminders
· Media campaigns
· Recall system
· Mobile unit
· Patient navigation
· Hiring outreach manager to develop strategies and a team to target populations with low screening rates
MB · Comprehensive letter campaigns
· Informative web site
· TV advertisement (run at select periods)
· Satisfaction surveys
· Accessibility – 2 mobile clinics, 4 fixed locations
· Social media promoting mobile clinics
· Invitation letters sent to all new 50-year-olds and new Manitobans
· Reminder and recall letters sent at appropriate intervals
· Screening Program web page on CCMB site that educates and provides for test requests
· TV ad runs in October. Promotional pieces in development that support tv ad
· Satisfaction survey sent to all clients testing positive who have gone on to have follow up investigation
· Interactive map showing active mammogram clinics
ON · Mass media (small and mass)
· Development of culturally safe materials and resources
· Correspondence campaigns (invitation, recall and reminder letters)
· Provider reminder and recall systems (Screening Activity Reports)
· Provider incentive strategies
· Participant navigation
Mass media (small and mass) and development of culturally safe materials and resources:
· Ontario Health (Cancer Care Ontario) has a Breast Cancer Awareness Month (BCAM) campaign each October. The campaign includes the development and dissemination of promotional materials to regions. These materials include images which are representative of diverse groups.
· The Ontario’s Ministry of Health will be leading a public campaign to remind people about the importance of regular cancer screening in September 2021 and have provided Ontario Health (Cancer Care Ontario) with support to develop additional strategies to support COVID-19 recoveryCorrespondence campaigns (invitation, recall, and reminder letters):
· The Ontario Breast Screening Program sends letters to eligible people inviting them to participate in screening by talking to their PCP and reminding them when it is time for their next screening test (recall letter).Provider reminder and recall systems (Screening Activity Reports):
· Ontario Health (Cancer Care Ontario) helps PCPs identify people eligible for screening or follow-up through the Screening Activity Report, an online tool that gives physicians who participate in Patient Enrolment Model practices the screening status of each of their enrolled age eligible patients (i.e., those who are overdue, never been screened or require follow up).Provider incentive strategies:
· To support family doctors in ensuring that their patients participate in relevant screening programs, the Ministry of Health has implemented Cumulative Preventive Care Bonuses. Through this program, eligible family doctors who practice as part of a Patient Enrolment Model, meaning, patients are formally rostered to a family doctor, may receive bonuses for maintaining specified levels of preventive care for their enrolled patients.

Participant navigation:
· After a participant has an abnormal screening result, their Ontario Breast Screening Program (OBSP) site will notify their family doctor or nurse practitioner and may help to schedule a timely follow-up appointment. A participant with an abnormal mammogram who does not have a family doctor or nurse practitioner will be assigned a doctor who will follow them to diagnosis. If the participant does have breast cancer, they will be referred to a specialist for further care and management.

QC · Provider reminders and recall systems
· Mobile screening clinics
· Providing transportation to screening services
NB · Education (groups)
· Participant reminders and correspondence
· Media (social media, radio, transit ads)
· Provider correspondence
· Bilingual program materials
· Community engagement for program feedback
· Leverage learnings from under screened population project
· Patient Navigation
· Offering virtual and in person education sessions on cancer screening programs in general, and specific to each screening site as requested by the public, health care providers, regional health authorities, community groups or special interest groups.
· Some health zones send letters to participants to remind of screening appointments or that it is time to re-book screening. Every screening site includes an additional information sheet about breast density with the screening result letters mailed to participants.
· Coordinated communication and awareness strategies are planned regularly throughout the year to promote and increase visibility of provincial cancer screening programs via various media such as radio ads, targeted digital ads, Facebook, Twitter, billboard and transit ads, website, animated and testimonial videos)
· Screening sites send result correspondence to primary care providers to alert them of screening results.
· ALL program correspondence, educational and promotional materials are offered in English and French. The program offers a toll-free phone line for public inquiries on cancer screening which is answered by bilingual staff.
· Public surveys have been offered by phone, online and following education sessions. Feedback provided to the program is collected and evaluated regularly.
· Plan to leverage the recommendations from the ongoing project ‘Developing Strategies for Underscreened Populations through Community Engagement’.
· Breast health navigation services are available to patients in most health zones across the province.
NS · Media (mass) · The coordinator for the mobile van places radio ads about upcoming mobile breast screening dates and locations.
PE · Business cards for physician office use
· Educational sessions with groups & new physician groups
· Media ads
· Health fairs
· Reminder letters for recalls
· Promotional items
· Extended hours of operation one day per week as well as Saturday appointments
NL · Client reminders
· Provider reminders and recall systems
· Patient navigation