What the INESSS recommendation says
Quebec is preparing to re-evaluate its approach to breast cancer screening after the Institut national d’excellence en santé et en services sociaux (INESSS) published an opinion on Monday afternoon. The document suggests that breast cancer screening could reasonably begin at age 45 for average‑risk individuals, while warning that any broad expansion of the program requires careful planning and sustained investment. The minister of Health, Christian Dubé, has since commissioned a formal analysis to determine whether the province should widen eligibility or adjust how screening is delivered.
The INESSS assessment focuses on balancing the benefits of earlier detection with the realities of capacity, costs, and the potential harms of overdiagnosis. While the report stops short of an immediate program expansion, it frames a path toward policy changes that would shift when and how women are invited to participate in population screening.
Why 45 now, and not an immediate expansion
The move to consider 45 as a starting point reflects evolving evidence about the age at which screening begins to provide meaningful benefit for many women, alongside concerns about resource constraints and the risk of unnecessary interventions. INESSS emphasizes that any change would need to be accompanied by robust public information campaigns, careful monitoring, and equitable access across urban and rural areas. The agency also highlights that expanding screening would require increased radiology capacity, more follow-up care, and stronger data systems to track outcomes and reduce disparities.
What comes next for Quebec
With the minister’s directive, INESSS will conduct a formal analysis of potential expansions to the organized screening program. The government will review the findings before deciding whether to broaden eligibility, alter screening intervals, or implement a staged rollout. Any changes are expected to be incremental to avoid disrupting current services and to ensure that the system can support a larger eligible population. Health authorities say that patient education and clinician guidance will be essential components of any transition.
Practical guidance for residents
For now, residents should stay informed about evolving guidance and consult with their healthcare providers about personal risk factors. Women with a family history of breast cancer or other risk factors may be advised to pursue screening options at an earlier age, while those within the current program’s target groups should continue to follow existing provincial recommendations. Clinicians are likely to offer updated information and referrals as policy decisions unfold, ensuring patients receive care aligned with current best practices and local resources.
Context: breast cancer screening as a public health priority
Breast cancer remains a leading health concern for women in Canada, and decisions about when and how to screen affect lives, budgets, and patient experiences. INESSS’s analysis aims to clarify the trade-offs involved in expanding a screening program, including access, equity, potential harms, and the overall impact on health outcomes. The province’s leadership notes that a thoughtful, evidence-based approach is essential to protect both patient well-being and the integrity of the health system.
Bottom line
While the idea of starting screening at 45 is gaining attention, any concrete changes in Quebec will depend on the forthcoming INESSS analysis and subsequent policy decisions. As talks continue, residents should discuss personal risk with their clinicians and stay tuned for officially announced guidelines and timelines.
