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about cancer system quality index (CSQI) breast cancer screening data

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Need help understanding the data contained on this site?

  • For each data source, information about data collection and analytical methods, limitations, the citation and additional resources can be found on the Data Sources and Methods page.

Cancer System Quality Index (CSQI) has been developed by the Cancer Quality Council of Ontario, and is provided by the Cancer Screening Evaluation and Reporting section of Cancer Care Ontario.


Original Source: Integrated Client Management System (ICMS) – Ontario Breast Screening Program (OBSP), Ontario Health Insurance Plan (OHIP) Claims History Database (CHDB), Ontario Cancer Registry (OCR)
Distributed by: Cancer Care Ontario (CCO)
Cite as: Cancer Screening Evaluation and Reporting, 2009-2016, Cancer Care Ontario.


Data Collection Methods

Breast cancer screening participation is determined using data from the following data sources:

  • Integrated Client Management System (ICMS) – Ontario Breast Screening Program (OBSP) mammograms
  • Ontario Health Insurance Plan (OHIP) Claims History Database (CHDB) – Non-OBSP mammogram and mastectomy claims
  • Ontario Cancer Registry (OCR) – Invasive and in-situ breast cancers
  • Registered Persons Database (RPDB) – Demographic information
  • Postal Code Conversion File (PCCF)+, version 6D – Residence and socio-demographic information

Mammogram identification:

  • Mammograms performed for screening purposes in the ICMS.
  • Mammograms identified using fee codes X178 and X185 in OHIP.
    • X178 for screening bilateral mammography was introduced in October 2010.
    • X185 was used for both screening and diagnostic mammography prior to October 2010. Since October 2010, has been used for diagnostic mammography only; however, some screening mammograms after October 2010 may still use X185 for claims.

Data Analytical Methods

  • Breast cancer screening indicator: Age-adjusted percentage of Region of Peel or Ontario screen-eligible women, age 50 to 74, who completed at least one mammogram within a 30-month period.
  • Inclusion criteria: Women living in Ontario aged 50 to 74 years at the index date. Index date is the midpoint of the reporting period (e.g., January 1, 2016 for 2015-2016).
  • Exclusion criteria: Women with a missing or invalid health number, date of birth, sex, postal code or LHIN. Women with a prior diagnosis of invasive or in-situ breast cancer before January 1st of the reporting period (defined as ICD-O-3 codes: C50), a morphology indicative of breast invasive or in-situ cancer, microscopically confirmed with a pathology report. Women with a mastectomy before January 1st of the reporting period (defined in OHIP by fee codes E505, E506, E546, R108, R109, and R117).
  • 2011 Canadian population used for age-standardization.
  • Public health unit was determined using PCCF+, version 6D, specifically residential postal code.


  • Historical Registered Persons Database address information is incomplete; therefore, the most recent primary address was selected for reporting, even for historical study periods.
  • The reason for testing cannot be obtained; therefore, tests performed for reasons other than screening (e.g., to investigate symptoms) are included.


Last updated: February 12, 2019

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