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Evidence to Improve Care

Screening Mammography for Women Aged 40 to 49 Years at Average Risk for Breast Cancer

Ontario Health Technology Advisory Committee Recommendation

  • Screening mammography in Ontario cannot be recommended for 40-to-49-year-old average-risk women.

  • Ontario should consider the addition of an identifier suffix to mammography in the Fee for Service Code, to determine the purposes for which mammography (i.e., diagnosis or screening) is being conducted for women 40 to 49 years of age.

Read the full OHTAC Recommendation Report

The risk of breast cancer increases with age. The rate of breast cancer among women 50 to 65 years old is 500 cases per 100,000 women – four times higher than among women 40 to 49 years old (140 cases per 100,000 women).

A mammogram is an x-ray to look for signs of breast cancer. For women aged 50 years and older, getting a mammogram as a periodic checkup is known to be effective in preventing deaths by detecting breast cancer in early stages. The effectiveness of screening younger women who do not have a high risk of breast cancer is still unsettled.

Health Quality Ontario Reviews Screening Mammography

In 2007, the evidence on screening women aged 40 to 49 years with average risk for breast cancer was reviewed. Based on that information, the Ontario Health Technology Advisory Committee decided there was not convincing evidence that screening mammography reduced deaths from breast cancer in this age and risk group. In 2010, after reviewing a new study published since its 2007 recommendation, the committee decided not to change its earlier recommendation.

Related Resources

Screening Mammography for Women Aged 40 to 49 Years at Average Risk for Breast Cancer: An Evidence-Based Analysis (PDF)
January 2007

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The Ministry of Health and Long-Term Care has accepted this recommendation.

The Ministry of Health and Long-Term Care has provided the following response: The Schedule of Benefits for Physician Services was revised in October 2010 to distinguish the use of mammography for screening and diagnosis.

Health Technology Assessment at Health Quality Ontario

As part of our core function to promote health care supported by the best available evidence, we use established scientific methods to analyze the evidence for a wide range of health interventions, including diagnostic tests, medical devices, interventional and surgical procedures, health care programs and models of care. These analyses are informed by input from a range of individuals, including patients and clinical experts. The Ontario Health Technology Advisory Committee — a committee of the Health Quality Ontario board of directors — reviews the evidence and makes recommendations about whether health care interventions should be publicly funded or not. Draft recommendations are posted on the Health Quality Ontario website for feedback. Final recommendations are approved by our board of directors and then shared with the Ministry of Health and Long-Term Care. For more detailed information, visit our Evidence to Improve Care pages.


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