Canadians are bombarded by many sources of evidence for health information. The number of studies, with variable quality, and trustworthiness, make it difficult to know what is important, from deciding how to quit smoking, the pros and cons of medications to decisions on screening for diseases like cancer.
It's also not easy for family doctors, nurse practitioners and other primary care clinicians to sift through this evidence for what is most applicable to their patients.
National guidelines
National clinical practice guidelines bring much-needed clarity to the deluge of scientific information. These recommendations, created by internationally respected groups like the Task Force, summarize the best available evidence to help primary care providers and patients make important decisions on diverse topics such as screening for various cancers, thyroid dysfunction, and chronic health conditions, as well as interventions aimed at prevention like tobacco use and falls.
“The Canadian Task Force on Preventive Health Care was formed decades ago to provide unbiased and trustworthy guidance for primary care providers around key issues related to screening and disease prevention,” said Dr. Guylène Thériault, a family physician, teacher of evidence-based medicine and Task Force Chair. “We tackle complex evidence about screening for colorectal, cervical and breast cancer and other topics. Through systematic methodology, Task Force members, content experts and evidence synthesis groups lead comprehensive reviews, then summarize this information with patient input to deliver evidence-based guidelines for primary care providers and for Canadians”.
The Task Force is led by a national, independent panel of health professionals whose core members are primary care providers. It includes family physicians, nurse practitioners, specialists and prevention experts, as well as people with expertise in evaluating evidence.
Breast cancer screening guideline update 2024
Breast cancer is a disease that touches many Canadians. That’s why the Task Force is committed to developing evidence-based recommendations on breast cancer screening for primary care clinicians and patients.
It is currently conducting a comprehensive review with both Task Force and external expertise assessing evidence, both past and current studies, including observational trials, randomized controlled trials and modelling to ensure that updated recommendations are based on the best evidence available.
For each guideline, the Task Force relies on subject matter experts and patient partners. The breast cancer screening guideline update includes four content experts - a clinical oncologist, a radiation oncologist, a surgical oncologist, a radiologist - and three patient partners. They have also engaged the TF-PAN (Task Force Public Advisors Network) to better understand what patients want to know. Task Force members also work closely with research teams from across Canada. Together, they are systematically reviewing and analyzing the evidence for the guideline to develop a state-of-the-art evidence summary. Using international best practices, the Task Force, with input from the content experts and patient partners, reviews the evidence and weighs potential benefits and harms of screening as well as patient values and preferences to develop recommendations.
What is the current guidance?
Both the existing 2018 guideline and the updated 2024 recommendations that will be released later in the spring are for women (people assigned female at birth) with no personal or extensive family history of breast cancer, and no genetic mutations or symptoms of breast cancer, like a breast lump.
The current guideline emphasizes that patients and their health care providers discuss the benefits and harms of screening so that patients can choose if they want to be screened. This approach recognizes differences in the relative value that individuals place on the potential benefits and harms of screening. It is important to note that people aged 40-74 who want breast cancer screening and are aware of the benefits and harms should have access to a mammogram.
Public input
The Task Force is using a multi-phased approach for the upcoming draft recommendations– to date, thousands of articles have been reviewed and recommendations are being deliberated. Next, the draft recommendations and tools will be released for stakeholder and public input this spring. The final guideline, and easy-to-understand patient and clinician tools will be available later this year.
The Canadian Task Force on Preventive Health Care operates independently, with funding by the Public Health Agency of Canada (PHAC). Its valued work aims to improve Canadians' overall health and well-being by addressing key issues and providing primary care clinicians with effective preventive strategies.
Dr. Guylène Thériault, Chair, Canadian Task Force on Preventive Health Care
Dr. Donna L. Reynolds, Family Physician, Assistant Professor and Public Health and Preventive Medicine Specialist