Dépistage systématique du cancer du sein au Québec

Abstract

Since the incidence of breast cancer is increasing there is an imperative need to promote mass screening for cancer in the Province of Quebec in order to detect the disease at its outset, to provide adequate treatment and to lower the mortality rate. To justify the expense of mass screening five criteria have been established; the frequency of the disease; high mortality rate; ease of diagnosis; chances of cure; availability of resources. In the case of breast cancer all these criteria are satisfied and indeed early detection improves the chances of cure and reduces the mortality rate. The existing physical resources for mass screening now exist in the Province of Quebec and financial costs could be covered by the Health Insurance Program, the Canadian Cancer Society and other voluntary organizations. Of the various methods of detecting breast cancer: self examination, clinical examination, mammography, xerography and thermography, it is proposed to use clinical examination and mammography together because of their specificity and speed of application. A screening program requires painstaking preparation and careful planning. Such a program cannot be implemented globally throughout the Province, because of the high costs. At first access must be restricted to women between 50 and 59 years old because they are the most likely to respond favourably to a treatment given at the presymptomatic stage of the disease and also because it is the age range where the disease is most frequent. The next priority would be women between 40 and 49 years of age since there are large numbers of breast cancer cases in that age range. The third group to be covered would be between 30 and 39 years old because of their youth and the speed of progress of the disease. The paper outlines a program of screening for the Province of Quebec.