Doctors in Powell River put their heads together recently to answer the question of how to help women without family doctors gain access to screening for breast cancer.
“I think this solution demonstrates the community-minded and collaborative approach that exists among local doctors,” said Dr. Chris Morwood, head of the Powell River Division of Family Practice, a non-profit medical society. “I’m really pleased for the community. Normally, changes in health care delivery are slow, but less than a week after identifying that hundreds of women in our community were not eligible for mammograms, local doctors found and implemented a solution to make sure all women could have breast cancer screening.”
BC Cancer Agency (BCCA), which has operated the Screening Mammography Program (SMP) at 38 fixed screening clinics across the province since 1988, requires women to provide the name of their family physician, nurse practitioner, or naturopathic doctor to have their test results sent to. Women between the ages of 40 to 79 who have a family doctor can book the mammogram directly without a doctor’s referral. Women who are without a family doctor could not register for the screening.
“For women at a high risk for breast cancer it was devastating,” said Maggie Hathaway, constituency assistant for Nicholas Simons, MLA for Powell River-Sunshine Coast.
The issue was first brought to the attention of Simon’s office earlier this month and Hathaway contacted Morwood and the Powell River medical community to see what could be done to address the issue.
BCCA confirmed that a physician must be responsible for receiving each mammogram report, so that any abnormal result can be appropriately followed up, said Morwood.
The mammogram screening process, X-raying women’s breasts, is seen as an effective way to give early diagnosis for breast cancer. According to BCCA, the test is so effective it can show abnormalities before they can be felt with a physical examination.
Dr. Pawel Makarewicz, head of surgery at Powell River General Hospital, and Dr. Piotr Pater have agreed to take responsibility for receiving and following up on all abnormal mammogram reports in the community for women without family doctors. Dr. Susan Horsfall, a general practitioner, has agreed to provide primary care for women who are diagnosed with breast cancer through the program.
While over 90 per cent of screening mammograms are normal, receiving an abnormal result may not be an indication that cancer is present. Women with abnormal screens are automatically scheduled for further testing.
“Thankfully, most abnormal screens turn out to be false alarms,” said Morwood, “but a percentage of these are not.”
According to BCCA statistics, about one in nine women will develop breast cancer in her lifetime. One in 28 women will die from the disease.
Women can call 1.800.663.9203 to book a mammogram. Screening is performed in the radiology department at the hospital.
Other major BCCA screening programs are available as well
Colon Check, the colon screening program for men and women ages 50 to 75, does not require having a family doctor (1.877.70.COLON).
Cervical cancer screening, or Pap test, is already available to women through the Public Health offices at the hospital (604.485.3310). Women 19 and under can drop in for a Pap test at the Youth Clinic (Tuesdays, 3:30 to 5:30 pm), and women over 19 can have a Pap test at the Options Clinic (Thursdays, 5:30 to 7:30 pm).
Prostate screening still requires discussion with a physician, as an exam is required and there is some controversy about PSA blood testing. Currently, patients without a family doctor can attend the emergency room at the hospital for this service, but hospital administration and local physicians are working together to find better primary care options for the new year.
