Key takeaways

There is variation in reported indicator outcomes among jurisdictional breast cancer screening programs across Canada. Several successes across programs are reported; however, the data also highlights opportunities for improvement.

• Overall, breast screening programs continue to make important efforts to improve the quality and delivery of breast screening services following the challenges presented by the COVID-19 pandemic. The impact of the COVID-19 pandemic on breast cancer screening has been extensive, increasing existing disparities. Current data is limited in providing insights on the nature of these disparities. The pandemic significantly impacted screening participation rates across jurisdictions, a setback in reaching the 70% national target. Jurisdictions continue to implement population-wide and tailored strategies to restore pre-pandemic screening volumes and reach underserved populations. See the Breast cancer screening in Canada: 2021-22 environmental scan for more information. Ensuring that high quality data is available to better understand existing disparities across jurisdictions is a key priority of the Canadian Cancer Data Strategy (CCDS).
• The abnormal call rate still exceeds the target and continues to be an area for program optimization across jurisdictions. Using the strategies outlined in the Pan-Canadian Framework for Action to Address Abnormal Call Rates in Breast Cancer Screening will enable screening programs to optimize their abnormal call rates, thus potentially reducing the harms associated with over-screening and unnecessary follow-up tests.
• There has been an improvement in positive predictive value across the country with most jurisdictions meeting the target of >6% for subsequent screens, suggesting that screening tests have a higher likelihood of truly detecting the disease. There is still room for improvement in meeting the target for initial screens.
• Wait time for a definitive diagnosis differed across jurisdictions. Most jurisdictions did not meet the national target on the percentage of individuals receiving a definitive diagnosis within the 5-week or 7-week timeframe (depending on whether a biopsy is needed). The observed results could be partially attributed to interruptions in screening and diagnostic services stemming from the COVID-19 pandemic.
• All jurisdictions met the target for the cancer detection rate for both initial and subsequent screens.

Monitoring and evaluating common indicators at a pan-Canadian system level allows us to better understand how jurisdictional screening programs are meeting the needs of the target population, implementing strategies to improve access for underserved populations, and moving forward in innovative ways following the COVID-19 pandemic.