Ontario to lower age for regular breast cancer screenings to 40

Ontario is lowering the age for regular, publicly funded breast cancer screenings from 50 to 40, which Health Minister Sylvia Jones says will help with early detection. 

Jones said Monday that the expansion will mean an additional 130,000 mammograms are completed in the province each year.

"Nearly 12,000 Ontarians are diagnosed with breast cancer each and every year," she said at a news conference announcing the change.

"We know early detection through regular screening with mammograms can save lives, detecting breast cancer before it has the chance to spread, and with this historic expansion more mammograms will be performed each and every year, ensuring breast cancer is caught earlier and treated sooner."

The move follows a draft recommendation from the U.S. Preventive Services Task Force earlier this year that said screenings in that country should start at 40 instead of 50, because evidence suggests that would have a moderate benefit in reducing deaths.

The change in Ontario means that starting in fall 2024, eligible women, non-binary, trans and two-spirit people between the ages of 40 and 74 can self refer for a mammogram every two years.

People can already get regular mammograms and breast MRIs between the ages of 30 and 69 if they qualify as high risk, such as those with a family history of breast cancer or people who carry certain genes known to increase the risk of breast cancer.

The ministry says that between now and next fall, sites that offer breast cancer screening will hire new staff and work with the government to develop a public reporting system so patients can see wait times provincewide.

Sherry Wilcox, who was diagnosed with breast cancer last year at the age of 44, said she started asking about mammograms when she turned 40, but was told she wasn't eligible.

"To all of the women who are breast cancer survivors and patients and to the families of those who have passed — this announcement is a recognition of what you have endured," she said.

"While it may be too late for us, this is an incredible opportunity for others going forward that hopefully will not have to bear the negative consequences of a later diagnosis. If you are a woman in your 40s, go, please, and get a mammogram and for everyone else tell your daughters, sisters, mothers, coworkers to get screened."

Screening shown to reduce mortality by up to 44%

Dr. Martin Yaffe, a co-program director of the imaging program at the Ontario Institute for Cancer Research, said screening has been shown to reduce mortality by up to 44 per cent.

"If the cancers are found earlier, often women can be spared the harsher aspects of therapy," he said in an interview.

"So they might be able to have a lumpectomy — or breast conserving surgery, as it's called — versus a mastectomy. They may be able to avoid chemotherapy, which is a nasty experience, and they may also be able to avoid having ... surgery in the armpit to remove lymph nodes."

It is also beneficial for the health system as a whole, he said.

"Some of my colleagues in Ottawa and myself have recently published a paper looking at the cost of treating breast cancer and shown very clearly that if you treat it at earlier stages, it's much less expensive, sometimes by a factor of 20 to 30 times less expensive than when you're treating advanced, more advanced cancers," Yaffe said.

Welcome news

However, he said the program would be even more beneficial if screening was offered to women in that age group annually, instead of once every two years. Premenopausal cancers tend to grow faster and be more aggressive, Yaffe said, meaning screenings at two-year intervals could still miss cases.

Dense Breasts Canada, a non-profit group that raises awareness about optimal breast cancer screening, said the news is particularly welcome for Black, Asian and Hispanic women, who have earlier onset and peak breast cancer incidence in their late 40s.

"Getting screened before age 50 allows thousands of women to have their cancer detected earlier, when it is easier to treat," executive director Jennie Dale wrote in a statement.

"Lives depend on early screening."

A spokesperson for Jones said Ontario Health is working on determining how many staff will need to be hired, so was unable to say at this point how much funding will go toward the expansion.