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The Subway That Took a Generation: Why the Eglinton Crosstown’s Delays Were Even Worse Than You Think

  Toronto has a long history of transit projects that drag on, but the Eglinton Crosstown LRT has become the city’s defining example of how complicated, political, and painfully slow building transit can be. Most people think of the project as something that started in the early 2010s and simply ran over schedule. The truth is far messier—and stretches back decades. A Project With Roots in the 1990s Long before shovels hit the ground in 2011, the idea of rapid transit along Eglinton was already alive. In the mid‑1990s, the TTC began digging tunnels for what was then called the Eglinton West Subway . Construction actually started—tunnels were being carved out under the street—until the project was abruptly cancelled in 1995. The partially built tunnels were filled in, and the corridor sat untouched for years. That early false start meant that by the time the Crosstown was revived as part of the Transit City plan in 2007, planners weren’t starting fresh. They were restarting a dr...
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Breast Cancer Screening Should Begin at Age 40, U.S. Panel Says

 

In a significant update, the U.S. Preventive Services Task Force (USPSTF) now recommends that women at average risk for breast cancer should begin screening mammograms every other year starting at age 40. This decision marks a departure from their previous guidance, which suggested initiating screening at age 50. Let’s delve into the details:

  1. Revised Guidelines:

    • The USPSTF’s influential recommendation, published in the Journal of the American Medical Association (JAMA), aligns with other major organizations such as the American Cancer Society, the American College of Obstetricians and Gynecologists, and the National Comprehensive Cancer Network. These organizations advocate for breast cancer screening to commence at age 40 or, at the very least, encourage discussions with healthcare providers about the risks and benefits.
    • By lowering the age for biennial screening to 40, the USPSTF acknowledges mounting evidence that more women under 50 are being diagnosed with breast cancer. Notably, Black women, who face a 40% higher mortality rate from breast cancer compared to white women, stand to benefit from earlier screening.
    • U.S. insurers are already required by law to fully cover mammograms for women over 40 who desire them, at least through the end of this year. The USPSTF’s recommendation ensures the continuity of this coverage under the Affordable Care Act.

  2. Why the Change?

    • The shift in guidelines reflects a growing understanding of breast cancer risk factors and the importance of early detection. Initiating screening at age 40 allows for timely identification of tumors, potentially saving lives.
    • Dense breasts, which nearly half of all women have, increase the risk of breast cancer. However, the task force currently lacks sufficient evidence to recommend additional screening with breast ultrasound or magnetic resonance imaging for these individuals.

  3. Expert Perspectives:

    • Deirdre Saulet, vice president of cancer care at Carrum Health, anticipates that more primary care doctors will recommend starting screening at age 40 for women of average risk.
    • Dr. Carol Mangione, chair of the USPSTF, emphasizes the importance of reducing confusion around the “right” age for screening.

In summary, the updated guidelines emphasize the critical role of early breast cancer detection, particularly for Black women and those with dense breasts. Regular mammograms starting at age 40 can lead to better outcomes and ultimately save lives. 

Remember, always consult with your healthcare provider to determine the best approach for your individual risk profile. Early detection remains our strongest weapon against breast cancer. 

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