Loss of the Scientific Ideal on the Altar of Political Stakes and Misinformation
Context and Summary: In May 2024, the publication by the Canadian Task Force on Preventive Health Care (CTFPHC or CanTaskForce) of draft guidelines advising against routine mammography screening for breast cancer in women aged 40 to 49 (in favor of shared decision-making between the patient and her doctor) sparked intense controversy.
Faced with political pressure and sustained attacks from various advocacy groups and Canadian specialists advocating for screening starting at age 40, the Canadian Federal Minister of Health ordered an external expert review. Despite expert support and their request to increase funding for CanTaskForce, the Minister permanently dissolved the task force’s work in March 2025 to replace it with a new state structure. This led Dr. Guylène Thériault to denounce political interference and the dismantling of an independent institution dedicated to primary care.
Her stance was published here in the BMJ: https://ebm.bmj.com/content/early/2026/07/13/bmjebm-2026-114670
The loss of an ideal: how politics and misinformed advocacy killed the Canadian Task Force
Dr. Guylène Thériault is a physician and clinician recognized for her training activities in Evidence-Based Medicine (EBM), a field in which she holds a graduate degree from the University of Oxford. She is also a fierce advocate for shared decision-making with patients. She serves as Vice President of Choosing Wisely Quebec and co-lead for primary care at Choosing Wisely Canada. She worked for a long time within the Canadian Task Force on Preventive Health Care, particularly on the development of breast cancer screening guidelines.
The article published in the BMJ is a reflection on the role of scientific evidence in public health decisions, the dangers of political pressure, and the importance of preserving independent bodies that produce evidence-based recommendations.
The author explains how the disappearance of the Canadian Task Force on Preventive Health Care on different guidelines including the one on breast cancer screening.
Cancer Rose had also relayed the evolution of events in real time during this deplorable affair.
The Task Force’s mission was to develop prevention recommendations based on a rigorous analysis of scientific evidence, evaluating both the benefits and harms of interventions, including, among others, mammography screening. In 2024, its new breast cancer screening recommendations sparked fierce controversy in Canada. Yet, they did not advise against screening in an absolute manner for women aged 40 to 49; rather, they recommended that each woman receive balanced information about the benefits and harms of screening in order to make a decision aligned with her values. If a woman wished to be screened after receiving this information, screening was to be offered to her. One cannot say the recommendation was completely overturning the table…
Despite this rather moderate approach, which can be described as conciliatory and focused on shared decision-making, pressure groups and several political leaders accused the Task Force of minimizing the benefits of screening and using inappropriate methods.
The author explains that these criticisms were often based on a misinterpretation of statistics: opponents highlighted a 50% relative reduction in mortality, whereas the Task Force prioritized absolute risks (for example, approximately one breast cancer death prevented per 1,000 women screened over 10 years), which is far more understandable to inform a woman in an individual choice.
In 2025, the Minister of Health suspended the Task Force’s activities even before the publication of an external expert report. Yet, that report ultimately concluded that the Task Force worked according to robust methods and even recommended strengthening its resources.
“Taking into account developments in the health system and growing expectations regarding equity, inclusiveness, and scientific rigor, it is essential that the Task Force continue to adapt its methods and mandate. Strengthening the diversity of perspectives, regularly updating recommendations, and fostering increased collaboration with stakeholders will help ensure more representative guidelines tailored to the needs of people living in Canada. By pursuing these improvements, the Task Force will be able to consolidate its role as a benchmark in preventive care and build public and health professional trust.”
Despite this, the suspension was extended, and the Task Force was dissolved in March 2026.
The author acknowledges that certain improvements were necessary (notably accelerating the production of recommendations and strengthening patient participation), but, in her view, reform would have been preferable to outright abolition.
According to Guylène Thériault, this decision sets a worrying precedent: political considerations and activist campaigns ultimately prevailed over an independent scientific approach. She also fears that the new entity (the National Advisory Committee on Preventive Health Services) will lose the “primary care” approach, the spirit of independence, and the vision focused on field reality and patient partnership.
She writes in this regard: “At one point, the proposed new name was the Canadian Task Force on Preventive Health Services (instead of Health Care), which is now the National Advisory Committee on Preventive Health Services. Bureaucrats may remove the care from the name, but caring should remain central to all work moving forward.”
Dr. Thériault advocates for the creation of an independent body, led by primary care clinicians, capable of producing recommendations based on the best available evidence while respecting patient choices and preferences.
Recent news supports the Canadian recommendation
The UK-Age trial clinical study in August 2020 had already hit the nail on the head: “Overall, there was no significant reduction in breast cancer mortality in the intervention group (screened from age 40) compared to the control group (without screening from age 40).”
Since then, two organizations broadly support the recommendations issued by the Canadians and clearly express themselves against recommending screening before age 50.
A- The ACP’s Position, April 2026
Read https://www.acpjournals.org/doi/10.7326/ANNALS-25-05116
Read https://cancer-rose.fr/en/2026/04/22/acpno-screening-before-50/
No routine screening before age 50 for the American College of Physicians (ACP): For women aged 40 to 49, the ACP categorically refuses to recommend generalized mammography screening.
It advocates an individualized approach (shared decision-making) taking into account harms, the benefit-risk balance, and patient preferences, relying on evidence available from randomized trials known for years. This is neither more nor less than what the Canadian group was proposing.
Furthermore, the ACP highlights that the best recommendations come from the Canadian group CanTaskForce and the ECIBC (European Commission Initiative on Breast Cancer) in terms of methodological rigor, clarity, and greater involvement of women’s choices.
B- The Position of the Federal Health Care Knowledge Centre in Belgium (KCE), July 2026
Read https://kce.fgov.be/sites/default/files/2026-07/KCE_423_Breast-Cancer-Screening_Belgium_Report.pdf
Read https://cancer-rose.fr/en/2026/07/09/belgium-no-extense-of-screening-ages/
In early July 2026, the Belgian Federal Centre issued a non-recommendation for mammography screening before age 50 and, in its press release, wrote:
“According to the Belgian Health Care Knowledge Centre (KCE), the benefits of expanding region-organized breast cancer screening campaigns to older or younger age groups would be insufficient compared to its drawbacks. In addition, the cost-effectiveness of expanded screening would be even lower than that of the current program, which is already open to question. Increasing screening frequency (every year instead of every two years) is not beneficial in terms of cost-effectiveness either. Adding ultrasound to mammography would increase the number of false-positive results without offering clinical value. Furthermore, it would only increase pressure on the healthcare system and budget. Currently, there are no sufficient reasons to support these adaptations.”
In this report, the Belgian KCE organization not only fiercely opposes expanding the screening age limits, but also takes the opportunity to critique the relevance and very disappointing effectiveness of the current system.
Coverage of the Affair by Cancer Rose
Our article covered the entire affair at the time and firmly supports the work of the Canadian Task Force on Preventive Health Care (CTFPHC / CanTaskForce). The group refused to lower the routine breast cancer screening age from 50 to 40, based on rigorous scientific methodology. Indeed, early screening in women aged 40 to 49 offers very little to no benefit while exposing them to a high risk of overdiagnosis and unnecessary treatments. The UK-Age trial clinical study mentioned above (August 2020) drove the point home: “Overall, there was no significant reduction in breast cancer mortality in the intervention group (screened from age 40) compared to the control group (without screening from age 40).”
Cancer Rose denounces the decision by Canadian Health Minister Mark Holland to suspend and subsequently dissolve the independent task force. In our view, this decision constitutes a serious attack on Evidence-Based Medicine (EBM), driven by certain opinion leaders (such as radiologists) and patient groups supported by lobbies and the imaging industry. These groups favor modeling studies with highly questionable and biased results, and their demands are driven by demagogic activism at the expense of real scientific data.
The consequences for healthcare, as we explain in our article, are disastrous because they effectively block the publication of several other guidelines in the final stages of development (prostate and lung cancer screening).
Our group Cancer Rose deeply regrets that objective and cautious information is thus confiscated in favor of a demagogic and consensus-driven rhetoric that primarily harms women’s health.
Dr. Guylène Thériault published her article in the BMJ EBM because two Canadian medical journal chose not to publish it
🛈 Nous sommes un collectif de professionnels de la santé, rassemblés en association. Nous agissons et fonctionnons sans publicité, sans conflit d’intérêt, sans subvention. Merci de soutenir notre action sur HelloAsso.
🛈 We are an French non-profit organization of health care professionals. We act our activity without advertising, conflict of interest, subsidies. Thank you to support our activity on HelloAsso.
