Can you trust your mammogram?

From the front page of today’s Globe and Mail:

About 150 hospitals and clinics across Canada are operating breast-cancer screening machines that have failed a national quality test, have never been tested, or are no longer being tested, causing health-care experts to worry that cancers may be missed.

For thousands of Canadian women, that means they are being screened on equipment that is too old or of questionable quality. Or they are being sent to a facility that has let its accreditation with the Canadian Association of Radiologists lapse, or has never applied for it.


In stark contrast, no mammography machine can operate in the United States without a licence from the U.S. Food and Drug Administration and an accreditation from the American College of Radiology.

The Canadian clinics don’t appear overly concerned though:

In Ontario, about 82 per cent of clinics are accredited, just below the national average of 85 per cent. That leaves 51 machines that are not.

One of them is in Mississauga and another is in Etobicoke, says Dr. Murray Miller, a radiologist who works in those clinics and who is also on the association’s accreditation committee. He refused to identify the two clinics that have unaccredited machines but said neither is accredited because both are brand new. He said he is pursuing accreditation for both.

“The bottom line is the quality is first rate,” Dr. Miller said, adding that he believes the mammography quality at unaccredited Ontario centres to be very high.

How does one state that quality exists without comparing it to a known standard? And shouldn’t customers be made aware of clinics that aren’t certified?

Other clinics don’t do it because they don’t see the benefit:

Linwell X-Ray Centre-Midtown Plaza in St. Catharines allowed its accreditation to lapse because it didn’t spell extra business.

Yet in a country where citizens have essentially no choice in the cost and delivery of healthcare, shouldn’t the providers be held to a least some minimum standard by law?