Health Canada has said four times, in public, that no thermography machine is authorized to screen for breast cancer. Clinics kept selling it. The women who paid for it were not told the difference between a warning and an enforcement action.
Thermography — also sold as digital infrared thermal imaging, DITI, thermal imaging, or simply “a thermogram” — uses an infrared camera to map skin surface temperature. That is the whole of what the instrument does. It is, functionally, a thermometer that draws a picture.
The claim built on top of it is that a developing breast tumour recruits blood supply, that the extra blood raises surface temperature, and that a camera can therefore see a cancer years before a mammogram can. The first two steps are physiologically real in a loose sense. The third does not follow, and has never survived testing. Skin temperature is regulated by a great many things, and it is not a reliable proxy for what is happening in deeper tissue.
A session runs to several hundred dollars. Images are frequently sent out of the country for interpretation. In Canada the service has been offered by naturopathic clinics, wellness centres, chiropractic offices, and independent “certified clinical thermographers” who hold no regulated health credential at all.
| The claim | What the record shows | Verdict |
|---|---|---|
| “Detects breast cancer eight to ten years before a mammogram can.” | Health Canada, twice on the record: it is not aware of any clinical evidence that thermography can be used effectively as a screening technique for the early detection of breast cancer. Canada's own health technology assessment agency, CADTH, reviewed the field in March 2012 and found no randomised controlled trials comparing thermography with mammography for screening in well women, and performance worse than mammography on sensitivity, specificity and predictive values. Interest in the technique as a screening tool had in fact already collapsed once, in 1977, after a report found its sensitivity less favourable than ultrasound and mammography. | No evidence |
| “The machine is Health Canada licensed.” | Some thermography devices are licensed in Canada — to measure skin temperature. Health Canada's own 2017 wording: they have been licensed “only to measure skin temperature, similar to a thermometer.” No thermography machine has been licensed in Canada to screen for breast cancer. Citing the licence to imply the screening use is authorized inverts the meaning of the licence. | Misleading |
| “It's FDA approved for breast screening.” | The FDA cleared telethermographic systems in 1982 as adjunctive only — alongside mammography, never in place of it. The FDA has since issued repeated safety communications warning that thermography is not a substitute for mammography, and in February 2019 sent a warning letter to a California imaging centre over marketing an unapproved device as a sole breast screening method. | Misleading |
| “A safe alternative to mammography — no radiation, no compression, so no risk.” | The risk of thermography is not physical, so “no radiation” answers a question nobody was asking. Health Canada named the actual risk plainly: if women rely solely on thermography results, there is a potential risk that cancer could go undetected. The harm mechanism is the false negative — a reassuring thermogram in a woman who has a tumour. | False framing |
| “Adding thermography raises survival by 61%.” | A figure of this kind was carried by a Canadian clinic and reported by CBC in 2012. It is not traceable to any controlled study of screening outcomes. No trial has ever measured breast cancer mortality with and without thermography, which is the only way such a number could be generated. | Unsupported |
| “Interpreted by a certified thermographer.” | “Certified clinical thermographer” and similar titles are issued by private trade bodies. They are not regulated health credentials in any Canadian province, confer no scope of practice, and are not overseen by any college. One such body trades under the name “College of Medical Thermography” and has certified report readers after roughly three days of training — a certifying business borrowing the word that patients associate with a statutory regulator. | Not a credential |
| “It finds risk, not cancer — so the warnings don't apply to us.” | This is the standard retreat position, adopted by several clinics immediately after the 2012 advisory. It does not survive contact with the same clinics' own promotional material, which routinely reverts to early-detection language. And a “risk marker” that has never been validated against outcomes is not a lesser claim — it is the same claim with a hedge attached. | Repackaging |
CADTH assesses; it does not regulate, license or pay. But the point stands on the dates alone: the evidence review existed, in Canada, at public expense, eight months before Health Canada issued anything — and Health Canada moved the day after a television broadcast rather than in the eight months after its own sector's assessment.
An insurer is not a regulator and a coverage decision is not a regulatory finding; we are not presenting it as one. But a large payer declining to reimburse a test has done an evidence review, published its conclusion, and kept it under periodic reassessment for three decades. That policy predates the earliest Canadian marketing documented on this site by six years, and Health Canada's advisory by seventeen. The evidence position on this technique was settled, written down and publicly available before most of the Canadian clinics selling it had opened.
On 27 November 2012, CBC News published an investigation that identified dozens of clinics across Canada offering thermography for breast examination, and noted that the practice was gaining ground with naturopaths in particular.
The response was, for a few days, unusually coordinated:
Then, in September 2017, Health Canada issued the reminder — thermograms are not a substitute for mammograms; the devices are licensed only to measure skin temperature; it would again follow up with manufacturers and again work with CBSA on non-compliant imports. The 2017 notice includes the sentence that tells you what happened in the intervening five years: Health Canada has previously communicated about this issue.
The advisory did not reach the public through Health Canada. It reached them, briefly, through a Canadian Press dispatch that ran on 29 and 30 November 2012 and then stopped. What ran far longer, and far more prominently, was the advertising.
QuackeryWatch has assembled eighteen clippings from Canadian newspapers between 2002 and 2019 — front pages, health features, a naturopath's own bylined column presented as editorial content, letters of correction from radiologists, a full broadsheet page of paid advertising, and an advertising feature signed by a chiropractor. The full file is What the Newspapers Ran. Three findings from it bear directly on this page:
In 2016 the Globe and Mail reviewed the advertising of licensed Ontario naturopaths and found breast thermography being promoted as a painless alternative to mammography, capable of detecting breast changes “before the growth of a tumour.” The practitioner removed the material after being contacted by the newspaper — which is to say the correction was produced by a journalist, not by a regulator.
QuackeryWatch's own complaint on this point, CONO file 18-003, was received on 5 February 2018 and acknowledged two days later by Deputy Registrar Jeremy Quesnelle. It alleged advertising and use of breast thermography as a breast cancer screening technique contrary to the November 2012 Health Canada advisory, and contravention of the College's Advertising Standard of Practice. The subject of that complaint, Dr. Brenda Tapp, ND, holds an active Ontario licence, does not appear on the College's discipline outcomes list, and has never been found guilty of misconduct. Her clinic's current advertising does not list breast thermography; we do not know when or why it was dropped and do not attribute it to the complaint.
In British Columbia, the naturopathic college ran a genuine advertising enforcement drive from May 2018, giving every registrant in the province until 21 January 2019 to bring public materials into compliance, with automatic referral to the inquiry committee and minimum $500-per-infraction fines afterwards. Twenty-seven registrants were placed under investigation. That campaign is real and was, by Canadian standards, aggressive — but it was triggered by CEASE therapy and anti-vaccine content, and no published outcome from it names thermography or an electrodermal device.
The absence of college action is not explained by the profession never having been asked. It was asked directly, within weeks of the advisory.
Health Canada did not simply publish and move on in November 2012. It sent a direct communication to the Canadian Association of Naturopathic Doctors restating its concerns. A discussion followed among the profession's principal Ontario bodies: the association, Naturopathic Doctors Ontario, the Clinical Therapeutics Committee of the Canadian College of Naturopathic Medicine, and the Board of Directors of Drugless Therapy — Naturopathy, which was then the province's naturopathic regulator and whose functions passed to the College of Naturopaths of Ontario when the current framework came into force in 2015.
What emerged publicly was a position statement from the CCNM Clinical Therapeutics Committee. Seven naturopathic doctors signed it, including the committee's chair. It concluded that the committee does not recommend screening breast thermography in naturopathic practice, and that it was concerned about uncertain benefits in the face of substantial harm.
The document is careful and well referenced, and it is worth reading in full rather than in summary. Two things in it deserve setting out properly, because both cut against how this page might otherwise be read.
On the evidence, the committee reported that the base supporting modern thermography as a standalone or adjunctive screening test amounts to a few small studies, pointing in incompatible directions. In one, examining patients already under high suspicion of cancer, sensitivity was 25% and specificity 85%. In another, sensitivity was 97% and specificity 44%. The positive predictive value reported in the first was 24% — meaning that of the women whose thermogram came back positive, roughly a quarter actually had a malignancy. No large study has evaluated the technique against death from cancer or total mortality, which is why, as the committee noted, no genuine risk-benefit analysis of it is possible.
On harm, the committee's emphasis is not the one this page has been making. Its stated principal concern is overdiagnosis — that thermography escalates the detection of lesions, particularly ductal carcinoma in situ, which would never have progressed to clinically significant disease, and that the women concerned are then carried into biopsy, radiation, chemotherapy or surgery they never needed. That is the opposite failure mode from the false negative described elsewhere on this page. Both harms are real and they are not alternatives; a test with poor sensitivity and poor specificity produces both, in different women, at the same time. But it would be a misuse of the committee's document to present it as agreeing with our emphasis. It does not.
The Canadian College of Naturopathic Medicine is the teaching institution — the accredited school that trains naturopathic doctors. Despite the word in its name it is not a regulator. And the committee's remit is narrower still: by its own description it is an advisory body concerned with clinical safety and efficacy in CCNM's own teaching clinics, advising the school's chief naturopathic medical officer on best practices, standards of care, record keeping, diagnostic procedures and therapies.
So the body that published the position had authority over the school's own clinics and nowhere else. It could not investigate a registrant in private practice, impose a term or condition on a certificate, issue a caution, or remove anyone from practice. It could publish a clinical opinion, and it did. The bodies in that same discussion which could have done any of the other things published no equivalent statement that we have been able to locate, and took no published action in the fourteen years since.
The rest of this section is our opinion, not the record. Everything above is sourced and checkable; what follows is what we think it means, and a reader who disagrees should still be able to use the material.
An absence of published decisions might ordinarily be explained by an absence of awareness — a regulator cannot act on what never reaches it. In our view that explanation is not available here. The federal advisory reached the profession's national association directly. The regulator of the day took part in the discussion that followed. The school then published a position against the practice. Everyone involved knew. The only body that said anything to the public was the one with no power to do anything about it.
We would add that the correction in the 2016 Globe and Mail case, and the corrections in the letters columns documented in our press file, were all produced by journalists and physicians writing on their own initiative. That is not how patient protection is supposed to work, and it is not a substitute for a regulator that publishes.
Health Canada / Health Products and Food Branch Inspectorate, Information Update 2012-178, “Thermography machines not authorized to screen for breast cancer,” 28 November 2012. • Health Canada, “Health Canada reminds Canadians that thermograms are not a substitute for mammograms for breast cancer screening,” 2017. • CBC News, “Health Canada issues advisory about thermography tests,” 28 November 2012, and “College of Physicians cracks down on thermography,” 29 November 2012. • Globe and Mail, “Are we being served by the regulation of naturopaths? Not if patients are still being misled,” April 2016. • CBC News, “Naturopaths still making ‘unacceptable’ number of dubious claims face minimum $500 fines,” and “27 B.C. naturopaths under investigation as college cracks down on misleading ads,” 22 January 2019. • Science-Based Medicine, “Thermography is Not Approved for Breast Cancer Screening in Canada.” • Canadian College of Naturopathic Medicine, Clinical Therapeutics Committee, “Screening Breast Thermography: Perspective from the Clinical Therapeutics Committee of the Canadian College of Naturopathic Medicine,” c. early 2013 (references accessed 5 February 2013), seven named naturopathic authors, corresponding author at ccnm.edu — which records the direct Health Canada communication to the Canadian Association of Naturopathic Doctors and the stakeholder discussion that followed, including the participation of the Board of Directors of Drugless Therapy — Naturopathy. Diagnostic-accuracy figures cited above are those the committee reports from Kontos et al., Clinical Radiology 2011;66(6):536-539, and Arora et al., American Journal of Surgery 2008;196(4):523-6. • U.S. FDA telethermographic system classification, subsequent safety communications, and the February 2019 warning letter to a California imaging centre. • Aetna, Medical Clinical Policy Bulletin number 0029, “Thermography,” effective 21 July 1995, last review 12 March 2026, next review 14 January 2027. • Canadian Agency for Drugs and Technologies in Health, “Infrared Thermography for Population Screening and Diagnostic Testing for Breast Cancer,” Issues in Emerging Health Technologies, issue 118, March 2012. • Centers for Medicare & Medicaid Services, National Coverage Determination 220.11, Thermography — breast lesions excluded 20 July 1984, general exclusion published in the Federal Register 20 November 1992. • Eighteen Canadian newspaper clippings, 2002–2019, retrieved from Newspapers.com and cited individually on the press record page. • CONO complaint file 18-003 correspondence (QuackeryWatch files).