PHASE II (1998-2003)

In June 1998, Health Minister Allan Rock announced the renewal of the Canadian Breast Cancer Initiative (CBCI) with stable, ongoing funding of $7 million per year. Phase II of the CBCI resulted from extensive consultations with breast cancer partners and stakeholders. A key goal of Phase II will be to take the knowledge gained and the cooperative spirit developed during the initiative's first phase and use them to strengthen the CBCI's collaborative and multidisciplinary approach to breast cancer issues. The objectives of the CBCI are to reduce the incidence of breast cancer, reduce mortality as a result of breast cancer and improve the quality of life of those affected by breast cancer and their support networks.

The areas of focus for Phase II are the following:

The Canadian Breast Cancer Research Initiative (CBCRI)

Over the next five years, Health Canada will provide $15 million to the Canadian Breast Cancer Research Initiative (CBCRI), a partnership created in 1993 among Health Canada, the Medical Research Council of Canada (MRC), the Canadian Cancer Society (CCS) and its research partner, the National Cancer Institute of Canada (NCIC). The MRC will contribute an additional $10 million over 5 years to the CBCRI and the NCIC will contribute another $10 million with funds raised by the CCS.

Under Phase II of the CBCI, the CBCRI partnership has been expanded to formally include the Canadian Breast Cancer Foundation (CBCF), the Canadian Breast Cancer Network and the Breast Cancer International Centre (BCIC). The BCIC (with funds primarily from Avon Canada) and the CBCF will each contribute $5 million over 5 years to the CBCRI. This consolidation of research support from government, voluntary and corporate sectors in the fight against breast cancer will ensure that the best research investments are made.

As a CBCRI partner and board member, Health Canada will promote inclusive, collaborative, multi-disciplinary research to support and improve evidence-based decision-making. Research will build on the accomplishments and achievements of Phase I of the CBCI - chief of which were increasing the amount of scientifically excellent breast cancer research in Canada and increasing the number of investigators in breast cancer research - and those of its new research funding partners. The research will concentrate on the causes of breast cancer and related aspects of prevention, treatment and care, and the quality and effectiveness of health services delivery. Some of the Research Initiative's activities include:

• supporting high quality research on the causes of breast cancer, and related aspects of prevention, early detection, treatment, quality of life, and health services
• continuing to focus on investigator-initiated, creativity-driven research
• identifying possible research priority areas and new research programs by obtaining input from the various stakeholder groups
• ensuring that breast cancer survivors are participants in all levels of decision-making with respect to research funding
• communicating and disseminating results more effectively through various channels to all target audiences

For more information on the CBCRI, please visit: www.breast.cancer.ca

Prevention, Early Detection and Quality Screening of Breast Cancer

Health Canada will continue to support the development of quality, organized screening programs in all provinces and territories, with an emphasis on consensus building around national breast cancer screening issues such as the target age and the required elements of a screening program. Emerging prevention, detection and screening issues (including the issue of genetic testing) will also be examined.

In addition, Health Canada will work with provincial and territorial governments and mammography experts through the Canadian Association of Radiologists, to improve the quality of mammography in Canada.

Surveillance and Monitoring of Breast Cancer

Health Canada will expand surveillance and monitoring to include data collection on breast cancer and breast cancer screening. Particular emphasis will be placed on surveillance of breast cancer screening occurring outside of organized screening programs.

The Department will continue to consolidate the Canadian Breast Cancer Screening Database, and will reinforce surveillance and monitoring activities for emerging issues, including treatment, primary prevention and risk factors associated with breast cancer (e.g. lifestyle factors, environmental contaminants and environmental tobacco smoke).

Enhancing Quality Approaches to Diagnosis, Treatment, and Care

Phase II of the CBCI will see further development of quality approaches to improve breast cancer diagnosis, care and treatment, including public and professional education. This will include an emphasis on continuing rigorous reviews of the scientific literature to address therapeutic situations not already addressed, or updating current recommendations, implementing and evaluating those clinical practice guidelines which currently exist and innovative approaches to enhancing communication skills in breast cancer and on developing a coordinated strategy to improve access to breast cancer information. The Canadian Breast Cancer Initiative also aims at providing persons with breast cancer enhanced communication skills to empower them to fully participate in the treatment decisions related to their care.

Health Canada will also support the synthesis and analysis of knowledge on issues such as primary prevention, genetics, alternative therapies, psycho-social support, and environmental factors.

Community Capacity Building

Assists the Canadian Breast Cancer Network to ensure it becomes a key and integral player at the national level, and provides a voice for Canadian women affected by breast cancer. In order to enhance the capacity of groups to participate in the breast cancer field, the following support is also provided:

• funding to community groups to develop networks;
• information on breast cancer to those diagnosed with the disease;
• to facilitate continuous communications between breast cancer groups, survivors and the CBCI.

Evaluation and Coordination

Strengthens the coordination of activities among groups involved in Phase II of CBCI, including the establishment of an External Advisory Group comprising major stakeholders, by way of evaluating key products, services and activities to provide evidence of the most viable and effective strategies to address breast cancer.