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about cancer system quality index (CSQI) cervical 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: CytoBase, 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, 2005-2016, Cancer Care Ontario.


Data Collection Methods

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

  • CytoBase – Pap tests
  • Ontario Health Insurance Plan (OHIP) Claims History Database (CHDB) – Pap tests, hysterectomy claims
  • Ontario Cancer Registry (OCR) – Resolved invasive cervical cancers
  • Registered Persons Database (RPDB) – Demographic information
  • Postal Code Conversion File (PCCF)+, version 6D – Residence and socio-demographic information

Pap test identification:

  • Pap tests identified in CytoBase, including those with inadequate specimens.
  • Pap tests identified using the following fee codes in OHIP:
    • E430A - add-on to a003, a004, a005, a006 when pap performed outside hospital
    • G365A - Periodic-pap smear
    • E431A - When Papanicolaou smear is performed outside of hospital, to G394
    • G394A - Additional for follow-up of abnormal or inadequate smears
    • L713A - Lab.med.-anat path,hist,cyt-cytol-gynaecological specimen
    • L733A - Cervicovaginal specimen (monolayer cell methodology)
    • L812A - Cervical vaginal specimens including all types of cellular abnormality, assessment of flora, and/or cytohormonal evaluation
    • Q678A - Gynaecology – pap smear – periodic – nurse practitioners
    • L643A - Lab Med - Microbiol - Microscopy - Smear Only, Gram/Pap Stain

Data Analytical Methods

  • Cervical cancer screening indicator: Age-adjusted percentage of Region of Peel or Ontario screen-eligible women, 21-69 years old, who completed at least one Pap test in a 42-month period.
  • Inclusion criteria: Women living in Ontario aged 21 to 69 years at the index date. Index date is the midpoint of the reporting period (e.g., July 1, 2015 for 2014-2016).
  • Exclusion criteria: Women with a missing or invalid health number, date of birth, sex, postal code or LHIN. Women diagnosed with an invasive cervical cancer prior to January 1st of the reporting period (e.g., January 1, 2014 for 2014-2016), prior diagnosis of cervical cancer (defined as ICD-O-3 codes: C53), a morphology indicative of cervical cancer, microscopically confirmed with a pathology report. Women who had a colposcopy and/or treatment within two years prior to January 1st of the reporting period (OHIP fee codes Z731, Z787, Z730, Z732, Z724, Z766, S744, Z720, Z729). Women with a hysterectomy prior to January 1st of the reporting period (OHIP fee codes E862A, Po42A, Q140A, S710A, S727A, S757A, S758A, S759A, S762A, S763A, S765A, S766A, S767A, S816A).
  • 2011 Canadian population used for age-standardization.
  • Public health unit was determined using PCCF+, version 6D, specifically residential postal code. RPDB address closest to the index date was used to assign postal code.


  • Pap test results are available in CytoBase only.
  • CytoBase includes only Pap tests analyzed in community-based laboratories in Ontario; Pap tests analyzed in Ontario hospitals and Community Health Centres are not captured in CytoBase.
  • It is difficult to determine whether a Pap test in CytoBase and/or OHIP was done for screening or diagnostic purposes, and therefore, some Pap tests included in these analyses may have been performed for diagnostic purposes.


Last updated: February 12, 2019

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