Ottawa halts work of task force on cancer screening, other care

Ottawa has paused the work of an independent task force that advises family doctors on subjects ranging from cancer screening to fall prevention, putting a temporary stop to the group’s activities before a much-anticipated external review is completed.

Federal Health Minister Mark Holland announced on Tuesday that he was suspending the work of the Canadian Task Force on Preventive Health Care, a federally funded panel of 15 experts whose processes have come under intense public scrutiny in part because they declined to lower the starting age for routine mammograms to 40 from 50.

Some doctors who had been calling for the task force to be overhauled or disbanded welcomed Mr. Holland’s decision, while the task force’s chair said she feared the pause would jeopardize work on five guidelines that were nearly finished, including updated recommendations on screening for cervical cancer and for depression in children and adults.

“What does it mean for all the years of work that have been put into these guidelines?” said Guylène Thériault, a Quebec family physician and chair of the task force. “It’s not like if you pause for a few months you can just start back. You cannot do that in the evidence world, because once you’ve been a few months out, you have to re-look at the evidence.”

Dr. Thériault said she was caught off guard when she learned of the pause during a virtual meeting with a senior official at the Public Health Agency of Canada on Tuesday morning. She was expecting an update on the progress of an external expert review panel, led by University of Waterloo president Vivek Goel, that was struck last year to examine the task force’s governance, mandate and processes.

Mr. Holland said in a statement Tuesday that the external panel members have finished gathering evidence and are finalizing a “robust set” of recommendations to modernize the task force.

“I also continue to hear important feedback directly from Canadians and key leaders in the area who raise their concerns on the existing guidance and process of the Task Force,” Mr. Holland said. “Considering these concerns, I have asked the Public Health Agency of Canada to pause the Task Force’s work until the External Expert Review panel finalizes its work and its recommendations can be fully assessed.”

The statement said the review is expected to conclude at the end of the month.

Anna Maddison, a spokeswoman for PHAC, said by e-mail that it is not known when the task force will resume its work. She added that the task force’s breast cancer screening guidelines, which were released in draft form last May, are paused until further notice, while a guideline on tobacco smoking cessation that was accepted by the Canadian Medical Association Journal last month will be published as planned.

Brandon Purcell, the advocacy manager for prevention and early detection at the Canadian Cancer Society, called the temporary suspension “an unfortunate but necessary disruption before the review panel’s recommendations are fully implemented.”

His organization was one of many that made recommendations to the external reviewers for improving the task force, including increasing the task force’s budget, assigning it permanent staff, giving patients a permanent voice in the task force’s processes and “ensuring robust ongoing engagement with subject matter experts.”

The question of how deeply to involve specialists who screen and treat people for certain diseases in the task force’s work has been hotly debated.

Dr. Thériault, the chair of the task force, said her group of volunteer experts in prevention and primary care is committed to hearing from subject matter experts while crafting its advice, but that final decisions must be left to task force members with no financial or intellectual conflicts of interest.

Some specialists have argued, however, that the task force does not adequately listen to doctors on the front lines of screening for cancer and other illnesses, leading task force members to put too much weight on out-of-date studies and too little emphasis on new evidence.

“It’s just so good to have a pause on what the task force has been doing, because the structure just is very flawed,” said Jean Seely, the head of breast imaging at The Ottawa Hospital and a member of the Coalition for Responsible Healthcare Guidelines, a group of doctors and patient advocates who have criticized the task force’s work, including its draft recommendation last year that average-risk women continue to wait until age 50 to get screening mammograms.

“This doesn’t just affect breast cancer, but it affects almost all the other guidelines,” Dr. Seely said. “There’s a whole slew of other health care professionals who are really overjoyed by this news.”