Breast screening in Canada, 2023-24

Specific communities, partners, and organizations

Yukon
The Yukon Mammography Program is working with the Yukon First Nations Cancer Care Project, as part of its Mobile Mammography Feasibility Group.

British Columbia
The BC Health Promotions team has hired an Indigenous Health Promotions Specialist, and they are working with her to integrate cultural safety in their current processes for breast screening. BC Cancer has partnered with First Nations Health Authority to develop an awareness and community engagement campaign.

Alberta
The Screen Test mobile program serves approximately 120 rural/remote and Indigenous communities in Alberta. Screening programs have been engaged in projects with people with low income, immigrants, and people without PCPs to improve access to screening. In addition, data linkage with First Nations and Métis Nation are informing equity actions.

Saskatchewan
Attending community events and presentations in Indigenous communities, for recent immigrants and refugees, as well as in rural/remote communities.

Manitoba
Working with newcomers, people with low income, specific cultural groups, people with mental illness or physical disabilities, and people living in Indigenous communities or remote locations.

Ontario
The OBSP has been worked with lived experience advisors from the Two-spirit, trans and nonbinary communities to improve access to safe and inclusive breast screening for this population. This work included updates to OBSP eligibility criteria to include transfeminine people with a history of feminizing hormone use, updating technical systems related to centralized correspondence to improve access to breast screening correspondence, and the development of guidance for the provision of safe and inclusive screening services for OBSP sites. As a part of expanding the Ontario Breast Screening Program to people ages 40 to 49, prevention specialists will be available in certain high needs communities to support tailored screening conversations. Over the coming years, the program will be developing culturally tailored program materials to support awareness and participation by underserved populations as well as supporting the expansion of Afro-centric screening models in Ontario.

The OBSP is working on broader provincial initiatives to support people without a primary care provider.

The Indigenous Cancer Care Unit and Regional Cancer Programs work with First Nations, Inuit, Métis and urban Indigenous communities to ensure cancer screening is accessible and effective.

New Brunswick
Working with First Nations community health clinics, Women’s Equality branch, and gender-diverse people.

Nova Scotia
Working with equity-deserving communities, such as African Nova Scotian communities in Cherry Brook and Kentville.

Working with First Nations community group Mi’kmaw Friendship Centre which serves over 7,000 Indigenous people living in Halifax.

Prince Edward Island
Health fairs have taken place with Indigenous communities to promote screening. Newcomers Society of PEI is giving recommended screening guidelines for breast (and colon, cervical), and encouraging recent immigrants to actively participate. They will arrange translators if needed.

Highlights in population outreach and engagement

Saskatchewan
Saskatchewan is developing community engagement resources alongside their prevention and community outreach partners.

New Brunswick
The New Brunswick Cancer Network has an existing communication, awareness, and marketing plan for our population-based cancer screening programs. Strategies include: radio advertisement, Government New Brunswick (GNB) Facebook, GNB Twitter, paid Facebook and Instagram ads, digital programmatic ads on popular NB websites (Kijiji, CBC, Yahoo, and The Weather Network), digital screens in regional health authorities and Service NB centres, digital billboards in major cities (Moncton, Saint John, and Fredericton), public transit ads (Moncton, Saint John, and Fredericton areas), digital news platforms (Telegraph Journal and Acadie Novelle), and Google search promotional ads.

Strategies used to identify and reduce barriers to screening participation

Northwest Territories
Currently working on the development of a new database that allows for a territorial BSP. Education on breast screening will be provided to health centres and healthcare providers. A registered nurse will take on the role of the Territorial Specialist — Breast Cancer Screening. This new role will help all healthcare providers, and anyone needing support or information about breast cancer and screening support.*

British Columbia
Mobile mammography services offered at the fixed/community centre sites serve participants with physical disabilities, including those who are wheelchair-bound.

Mobile mammography vans serve rural/remote geographic areas and hard-to-reach communities.

Specific cultural groups and non-English speaking clients are served by the mobile mammography vans, including communities at different places of worship (gurdwaras, temples, etc.).

Mobile mammography vans also serve participants who are incarcerated.

Alberta
Continued discussions with the Alberta First Nations Information Governance Centre to develop an ongoing dashboard to monitor progress in decreasing disparity in cancer screening. Determining accessibility to immigration data. Working with LGBTQ2S+ groups to develop inclusive screening resources.

Saskatchewan
Geography analysis work is being completed to identify travel time for communities in the province. Mobile screening services will bring mammography closer to communities. Community outreach resources are being developed for use. An evaluation tool for a mobile route is also being developed.

Manitoba
The program works in consultation with community groups and organizations to ensure that all resources utilize inclusive language. Breast cancer screening guidelines includes specific language for transgender men and women, and non-binary people.

Ontario
Ontario Health has conducted an analysis on screening participation and follow up after an abnormal test result by two indexes (material deprivation and ethnic concentration) and on screening participation by postal code region. Results are available shared via a public report that may help inform regional initiatives to address equity issues (cancercareontario.ca).

Engagement with Regional Cancer Programs (RCP) and work with Regional Primary Care Leads has been important in identifying equity-deserving populations within each region and tailoring recruitment strategies to ensure they are appropriate and effective.

New Brunswick
Based on feedback received through our provincial cancer screening line, GIS mapping, and the RHAs who operate mammography services, the breast cancer screening program may identify equity-deserving populations or communities with barriers to screening. These include:

• Low-income
• Recent immigrants and refugees
• Non-English and non-French speakers
• People without a PCP
• People with comorbidities or chronic illness
• People with mental illness
• People with physical disabilities
• People who are houseless
• Specific geographic areas
• Federally insured individuals (armed forces, RCMP, refugees, immigrants)
• Gender-diverse people

Nova Scotia
The Nova Scotia Breast Screening Program (NSBSP) identified equity-deserving populations in previous years.

Prince Edward Island
Recent community engagement survey with recent immigrants and Indigenous community members was completed to identify gaps in services.

Newfoundland and Labrador
The breast screening program has operationalized a satellite breast screening centre in Happy Valley-Goose Bay (northern remote location with significant First Nations, Inuit, and Métis population). Imaging and reporting are done through local hospital, and results communication (letters) and patient navigation are organized by program at main hub site.

_{*NT: Work includes education, media (small and mass), client reminders, recall system, patient navigation, and healthcare provider cultural competency training.}