We appreciate Dr Laycock’s letter about our Clinic. We have just a few comments:

•    The risk assessment tools and modifiable risk factors we focus on are based on the most widely accepted guidelines based on the best current scientific evidence. We agree with Dr Laycock that obesity reduction is important for reducing breast cancer risk.

•    Primary care providers are crucial to effective cancer prevention, and we salute Dr Laycock’s commitment to this in his practice. However, as shown in the National Canadian Family Physician Cancer and Chro­nic Disease Prevention Survey,[1] many primary care physicians do not include full counseling about risk factors in their practice, with the most common barrier being lack of time. Even when patients are counseled by their physicians, they generally need to hear a message more than once, particularly through a specialty clinic such as this one. We see our clinic as complementing primary care.

•    The clinic is a pilot project. We are not proposing that women across the province come to Vancouver for the purpose of attending it. However, based on the overwhelmingly positive responses we have received from clinic attendees so far, we are considering ways to provide clinic services to a broader population through e-health technology. 

If readers of the BCMJ are interested in making this kind of program available to their patients, we invite them to contact us.
—Carolyn Gotay, PhD, Bonnie McCoy, MA,
Marliese Dawson, BA, Joseph Ragaz, MD

References

1.    Katz A, Lambert-Lanning A, Miller A, et al. Delivery of preventive care: The national Canadian Family Physician Cancer and Chronic Disease Prevention Survey. Can Fam Physician 2012;58:e62-69.