OAR warned province of critical need for digital mammography equipment in 2010

OAKVILLE, ON, May 14, 2013 /CNW/ - "The Ontario Association of Radiologists (OAR) is deeply concerned that the Ministry of Health and Long Term Care (MOHLTC) still fails to take women's health seriously by offering a band-aid solution of $25M to fix a $74M equipment problem we identified in a 2010 report, they chose to ignore," said OAR President, Dr. Mark Prieditis in response to the recent equipment funding announcement.

"And, it is unconscionable that the Ministry would jeopardise women's lives by withholding, since last November, a report containing vital information suggesting that computed radiography (CR) mammography has a lower cancer detection rate that other mammography equipment."

Dr. Prieditis said the report sponsored by Cancer Care Ontario (CCO) and only made available to the OAR last Friday, underscored the urgent need identified by Ontario radiologists two years ago.

"Had the Ministry of Health listened and acted in October 2010 on the OAR's recommendations concerning the critical need for digital mammography to provide Ontario women with the best diagnostic equipment to detect breast cancer, we would not be having this crisis today."

The OAR report "Delivering Modern Digital Mammography in Ontario: A Plan to Modernise Ontario's Mammography Equipment", clearly identified that Ontario lags behind the rest of Canada in its adoption of digital mammography services and that the province had no plan or stated policy to transition the province to full-field digital mammography equipment (FFDM). The report provided a plan to transition the approximately 150 film mammography and CR mammography units, in place in the province in 2010, with FFDM.

CR Mammography equipment, which was approved by Health Canada, the Ontario Breast Screening Program (OBSP) and MOHLTC has become widely used throughout the province because the Ontario government has chronically underfunded the purchase and operation of FFDM diagnostic equipment, leaving CR as the only digital option. Close to a third of the mammography equipment in Ontario is CR.

Dr. David Jacobs, Section Chair for the Diagnostic Imaging Section of the Ontario Medical Association, echoed Dr. Prieditis' concerns adding that Ontario radiologists have been on record with MOH for many years about chronic underfunding for the purchase and operation of diagnostic equipment, particularly mammography, and that the Ministry should work with radiologists to find an acceptable solution.

"The significance of this failure to listen to radiology experts is that an unknown number of the 1.1 million women who annually receive a breast screen or diagnostic mammogram have had their health care compromised," Dr. Jacobs said.

"Ironically, in May 2012 Health Minister, Deb Matthews, promised there would be no impact on Ontario patients when she unilaterally slashed all radiology services and further reduced overhead/operational funding that had already been frozen for more than 20 years," Dr. Jacobs said.

Dr. Prieditis said the OAR is also deeply concerned that the MOHLTC in their haste to bury their mistake will not buy current FFDM equipment with the capability of adding breast tomosynthesis, a current feature that has proven to detect up to 30% more cancers when used to screen women for breast cancer.

"The highest standard of patient care remains our priority, and Ontario women must have access to the best mammography technology available" Dr. Priedits said.

Dr. Prieditis also criticised the plan for falling short in addressing the crisis by excluding 40 or more hospitals and publicly funded radiology clinics from the equipment purchase because they use analogue equipment rather than CR mammography, a direct impact of the chronic underfunding of Ontario's diagnostic imaging infrastructure.

Dr. Jacobs added that the underfunding issue is of immediate concern to the facilities that will be eligible to receive the new FFDM equipment, but will be unable to cover the substantially higher operating costs, which was the reason why facilities were forced to adopt CR as a second choice solution.

The OAR is further concerned that CCO bureaucrats are serving as the Ministry's purchasing agent, using an RFP, even though they have no experience in the selection of highly sophisticated technical equipment used by radiologists and refuse radiologists' expert advise on the criteria necessary to select the best equipment versus equipment selection guided by the lowest cost.

The OAR offered to assist CCO to ensure the RFP is developed with adequate external expert consultation to safeguard the public interest on both a medical and fiscal level, but that offer was ignored.  A review of the proposed RFP document indicated that many benefits that should occur as a result of this announcement will be missed, including providing Ontario taxpayers with best value for money, and more importantly, the best equipment to find breast cancers earlier.

Dr. Prieditis noted that the CR discovery comes at a time when the MOH is promoting an undefined Quality Management Program for mammography, knowing full well that they had created this crisis by failing to act on expert advise provided by Ontario radiologists.

"The fact that the government has caused this crisis through yet another failure to consult their radiology experts is scandalous and should result in a thorough investigation into how major public policy decisions are made concerning health care in this province", Dr. Prieditis said.

For a copy of the 2010 OAR report Delivering Modern Digital Mammography in Ontario: A Plan to Modernise Ontario's Mammography Equipment, visit the OAR website: www.oar.info

SOURCE: Ontario Association of Radiologists

Dr. Mark Prieditis 905-337-2680 or 1-800-616-6277.