More Cancer Screening Means Little Without Awareness: Why Primary Care Must Lead the Way
Adapted from commentary by Andrea Seale, CEO, Canadian Cancer Society
Over the past several decades, breast cancer outcomes in Canada have improved dramatically. Since the early 1990s, breast cancer death rates have fallen by more than 45 per cent, a success largely driven by earlier detection through screening and advances in treatment.
Yet an uncomfortable truth remains: screening saves lives only if people know they are eligible and can access care in a timely way. Without awareness, even the best policies fall short.
Breast Cancer Is Not Just a Disease of Older Women
For years, breast cancer messaging focused almost exclusively on women aged 50 and older. This narrow framing left many younger women uncertain about their risk and, in some cases, overlooked.
The evidence tells us two critical things:
- Approximately 13 per cent of breast cancer diagnoses occur in women aged 40–49
- When breast cancer is detected early, outcomes are excellent: nearly 100 per cent five-year survival for stage 1 disease, compared with just 23 per cent at stage 4
Early detection matters. Timing matters. And awareness matters.
Expanded Screening Eligibility: Progress, But With Gaps
In response to emerging evidence and international guideline changes, several Canadian provinces, including Ontario, have lowered the minimum age for breast cancer screening. Many women can now self-refer for screening mammography starting at age 40.
This is an important and welcome shift. However, recent data show that policy changes alone are not enough.
A 2025 survey conducted during Breast Cancer Awareness Month revealed that:
- Two-thirds of women in Canada do not know the screening eligibility age in their province
- Only 65 per cent of primary care physicians correctly identified the minimum age
These gaps highlight a systemic challenge: eligibility changes are moving faster than public and professional awareness.
Why Primary Care Clinics Are Central to Awareness
At Orleans Family Health Clinic, we see firsthand how confusion around screening eligibility delays care. Patients often assume they are “too young” for screening, or wait for symptoms before raising concerns, by which time opportunities for early detection may already be lost.
Primary care plays a crucial role by:
- Proactively informing patients of updated screening guidelines
- Identifying personal and family risk factors
- Supporting self-referral and appropriate follow-up
- Coordinating care when abnormal results require further assessment
Screening is not a single test; it is part of a continuous relationship between patients and their care team.
System Capacity Must Match Policy Ambition
Expanded eligibility also requires investment. More screening means more demand on imaging services, follow-up diagnostics, and specialist referrals. Without adequate infrastructure and coordination, wait times can grow and confidence in the system can erode.
Equally important is ensuring that frontline healthcare providers are equipped with clear, consistent information so they can guide patients confidently and accurately.
Turning Policy Into Lives Saved
Informing newly eligible age groups does not happen overnight. Differences in provincial eligibility criteria, notification strategies, and access pathways make confusion understandable, but not acceptable.
Lasting progress requires collaboration between governments, healthcare institutions, advocacy organizations, and primary care clinics.
Screening has already transformed breast cancer from one of the deadliest cancers into one of the most survivable. Policy changes create momentum, but awareness, access, and sustained investment are what ultimately save lives.
If you are unsure about your breast cancer screening eligibility or would like to discuss your personal risk, the team at Orleans Family Health Clinic is here to help.
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