This indicator measures the percentage of Ontario screen-eligible individuals, 50-74 years old, who were overdue for colorectal screening in each calendar year. Overdue is  defined as not having any of the following:

- Fecal Occult Blood Test (FOBT) in the last 2 years

- Colonoscopy in the last 10 years

- Flexible sigmoidoscopy in the last 10 years

A lower percentage is better.

Public reporting

Effective, Timely

Outcome

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 This indicator does not capture tests performed as part of the Registered Nurse Flexible Sigmoidoscopy Project.

•Multiple claims with the same Health card Number and service date were assumed to be a single claim •Each individual was counted once regardless of the number of tests performed •Some methodology changes are made for 2015 analysis (flexible sigmoidoscopy timeframe is changed form five to ten years) Neighbourhood income quintiles for urban residents only. LHIN assignment was determined using PCCF+, version 6C; residential postal code was used to identify LHIN and individuals with unknown/missing LHINs were excluded from the analysis. This was a Quality Improvement Plan (QIP) additional indicator for 2018/19, however retired from 2019/20 Neighborhood percent immigrant was determined using PCCF+; this indicator divides DAs into three categories according to the percentage of immigrants: low immigrant (≤ 27% immigrant population), moderate immigrant (27.1-51.8% immigrant population), and high immigrant (≥ 51.9% immigrant population) • Neighbourhood income quintile was determined using PCCF+; this indicator was based on income quintiles developed by Statistics Canada; income quintiles range from 1 to 5 (low to high) Rural or urban residence was determined using PCCF+. This indicator was based on whether individuals lived within a census metropolitan area (CMA), census agglomeration (CA) or Influenced Zones (MIZ) which takes into account population size, distance and commuting flow between rural and small towns and larger centres. o Urban: CMAs or CAs with a core population of 10,000 or more and 50+% of the population commute to a CMA/CA. o Rural: Areas with a core population of <10,000 and 30-49% of the population commute to an urban area (referred to as strong MIZ in Statistics Canada's classification) o Rural-Remote: Areas with a core population of <10,000 and 5-29% of the population commute to an urban area (referred to as Moderate MIZ in Statistics Canada's classification) o Rural-Very Remote: Areas with a core population of <10,000 and 0-4% of the population commute to an urban area, also includes non-urban parts of Territories (referred to as Weak MIZ, No MIZ, Territories outside CAs in Statistics Canada's classification)

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