A 104-page report was released on Friday by the external review panel, led by University of Waterloo president Vivek Goel.Fred Lum/The Globe and Mail
A federally appointed expert panel is recommending that the Public Health Agency of Canada modernize and reform a task force that advises family doctors on preventative care subjects ranging from breast cancer screening to fracture prevention.
The governance, mandate and processes of the Canadian Task Force on Preventive Health Care, an independent panel of 15 medical experts that creates national guidelines on preventative health care, have been under review since last May.
The examination was set in motion by former federal health minister Mark Holland after the task force updated its recommendations on breast cancer screening guidelines. The task force came under intense scrutiny for its decision to not lower the starting age for routine mammograms to 40 from 50.
A long-awaited 104-page report was released on Friday by the external review panel, led by University of Waterloo president Vivek Goel.
Mr. Goel, in the report, wrote that the task force’s work should resume and said the panel’s recommendations will help modernize its approach to health guidance at a time when public trust in health care is being challenged.
“While the Task Force is widely respected for its scientific rigour, there is a pressing need to modernize its approach to be more inclusive, transparent, and responsive to the diverse realities of health care delivery across Canada,” wrote Mr. Goel.
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Federal Health Minister Marjorie Michel, in a statement on Friday, said the Public Health Agency of Canada will “immediately begin working with experts and stakeholders on the review and the implementation of the recommendations.”
She wants the modernized task force to be operational by next April.
The task force’s work has been paused since March, a decision made by Mr. Holland as the external review was being finalized. Some doctors welcomed the pause, while the task force’s chair voiced concerns it would jeopardize existing efforts.
Twelve recommendations are included in the report that focus on better defining the mandate, structure and function of the task force; strengthening its evidence intake; prioritizing equity-centred engagement; and ensuring the makeup of the task force is representative of the community it aims to serve.
Organizations, including the Canadian Cancer Society, Breast Cancer Canada and Dense Breasts Canada, applauded the report’s findings and are optimistic that changes will help reform how health guidance is developed, particularly for breast cancer screenings.
Last May, the task force released its update to national breast screening guidelines. The task force recommended that average-risk women in their 40s who want a mammogram could get one every two to three years, but stopped short of lowering the general starting age to 40.
This was despite other organizations, such as the Canadian Cancer Society, in addition to provinces such as Ontario and Newfoundland and Labrador, recommending mammography begin at that age.
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Eddy Lang, a task force member and professor of emergency medicine at the University of Calgary, said he is “quite thrilled” with the recommendations, particularly the idea of co-ordinating more closely with provinces.
“This report is a validation of what we do, the importance of the task force and the need to improve and build,” he said.
“We’re going to be working with PHAC to figure out exactly how to implement these recommendations, including which of the projects that are already in active development will continue to the finish line.”
Martin Yaffe, a senior scientist at Sunnybrook Health Sciences Centre whose research focuses on early detection of breast cancer through imaging, said the task force, when it resumes, should prioritize a review of mammogram guidelines.
He said dropping the age recommendation will save lives and reduce the number of women who start treatment when the cancer is already fairly advanced.
Over all, Dr. Yaffe said the recommendations put forward by the review panel are broad but is hopeful they will address long-standing issues, such as the standards for gathering evidence and how members are appointed.
“The main feature I see is this desire to really rebuild the task force pretty much from the ground up and I think that’s great,” he said. “It all depends on the implementation.”
