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

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  • 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: Ontario Health Insurance Plan (OHIP) Claims History Database (CHDB), Colonoscopy Interim Reporting Tool (CIRT), Laboratory Reporting Tool (LRT), Ontario Cancer Registry (OCR)

Distributed by: Cancer Care Ontario (CCO)

Cite as: Cancer Screening Evaluation and Reporting, 2013-2016, Cancer Care Ontario.


Data Collection Methods

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

  • Colonoscopy Interim Reporting Tool (CIRT) - ColonCancerCheck (CCC) program colonoscopy records
  • Laboratory Reporting Tool (LRT) – CCC fecal occult blood tests (FOBTs)
  • Ontario Health Insurance Plan (OHIP) Claims History Database (CHDB) – Colectomy claims, non-CCC and CCC FOBT, colonoscopy, flexible sigmoidoscopy
  • Ontario Cancer Registry (OCR) – Resolved invasive colorectal cancers
  • Registered Persons Database (RPDB) – Demographic information
  • Postal Code Conversion File (PCCF)+, version 6D – Residence and socio-demographic information

Colorectal cancer screening identification:


  • Program CCC FOBT identified in LRT or OHIP using code L179A
  • Non-program FOBT identified using fee code L181A in OHIP


  • Identified using fee codes Z555A, Z491A-Z499A in OHIP or CIRT

Flexible sigmoidoscopy

  • Identified using fee code Z580A in OHIP

Data Analysis Methods

  • Colorectal cancer screening indicator: Percentage of Region of Peel or Ontario screen-eligible individuals, 50-74 years old, who were overdue for colorectal screening. Individuals were considered overdue for colorectal screening if they:
    • did not have an FOBT within the last two years (Jan 1 of the previous year to Dec 31st of the calendar year of interest) AND
    • did not have a colonoscopy in the last ten years (Jan 1 nine years prior to the calendar year of interest to Dec 31st of the calendar year of interest) AND
    • did not have a flexible sigmoidoscopy in the last ten years (Jan 1 nine years prior to the calendar year of interest to Dec 31st of the calendar year of interest)
  • Inclusion criteria: Individuals living in Ontario aged 50 to 74 years at the index date. Index date was defined as January 1st of each year.
  • Exclusion criteria: Individuals with a missing or invalid health number, date of birth, sex, postal code or LHIN. Individuals with an invasive colorectal cancer prior to January 1st of the calendar year of interest (defined as ICD-O-3 codes C18.0, C18.2-C18.9, C19.9, C20.9), a morphology indicative of colorectal cancer, microscopically confirmed with a pathology report. Individuals with a total colectomy prior to January 1st of the calendar year (OHIP fee codes S169A, S170A, S172A).
  • 2011 Canadian population used for age-standardization.
  • Public health unit was determined using PCCF+, version 6D, specifically residential postal code.


  • Historical RPDB address information is incomplete; therefore, the most recent primary address was selected for reporting, even for historical study periods.
  • FOBTs in hospital labs could not be captured.
  • A small proportion of FOBTs performed as diagnostic tests could not be excluded from the analysis.


  1. Colorectal Cancer Screening Participation Methodology, Cancer System Quality Index, Cancer Quality Council of Ontario.

Last updated: February 12, 2019

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