Perspectives from a multi-stakeholder workshop for implementing a risk-stratified breast cancer screening program in Canada

Implementing population-wide risk-stratified breast screening (RSBS) requires coordinated planning across diverse stakeholders and adaptation within complex healthcare systems. We convened a multi-stakeholder workshop with 34 policymakers, breast screening program leaders and healthcare professionals across Canada. Participants co-envisioned an RSBS program and focused on defining care pathways, the implementation roadmap, stakeholder engagement, and workforce training. A national, flexible RSBS strategy was proposed with multiple entry points and timings for risk assessment, interoperable information technology systems, phased roll-out, and an embedded learning healthcare system. The resulting actionable plans support RSBS implementation in Canada and offer transferable insights for planning RSBS in varied international settings.