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Comparisons

How does Ontario compare?

“Working together to create the best cancer system in the world,” is Cancer Care Ontario’s vision. Is Ontario succeeding?

To find out, we compared Ontario’s performance with national and international data, where available. The selected findings show where Ontario is doing well and opportunities exist for improvements relative to other jurisdictions.

A note on jurisdictional comparisons

Identifying comparable data and measures from multiple jurisdictions is challenging. When interpreting these findings, be aware of differences in data definitions, methodologies and years used for indicators measured outside of Canada. The design and context of other organized screening programs may also differ from Ontario’s. However, cross-jurisdictional comparison is still useful to provide a broad indication of how well Ontario is performing compared with other jurisdictions.

Modifiable Risk Factors With Jurisdictional Comparators<br />

Source: See Data Tables tab for source information.

Note: Left arrow means desired direction is down. Right arrow means desired direction is up.

Alcohol consumption (excess)
REGION PERCENTAGE (%)
British Columbia 8.5
Alberta 8.4
Saskatchewan 7.5
Manitoba 7.7
Ontario 7.8
Quebec 9.7
New Brunswick 7.2
Nova Scotia 8.0
Prince Edward Island 7.6
Newfoundland 8.7
Nunavut 8.0
Northwest Territories 16.2
Yukon 11.7

Source: 

Overweight/obesity
REGION PERCENTAGE BOTH SEXES (%) PERCENTAGE MEN (%) PERCENTAGE WOMEN (%)
Netherlands 47.6 50.2 45.0
Ontario 62.8 68.4 57.0
Sweden 49.9 56.6 42.9
United States 65.1 71.2 59.3

Source:

Smoking
REGION PERCENTAGE (%)
Ireland 20.0
New Zealand 14.9
Ontario 17.0
United Kingdom 17.3
United States 17.1

Source:

Breast Cancer Indicators With Jurisdictional Comparators<br />

Source: See Data Tables tab for source information.

Notes:

  1. Excludes modifiable risk factors.
  2. Left arrow means desired direction is down. Right arrow means desired direction is up.

Data Table 2: Breast Cancer Indicators With Jurisdictional Comparators

Cancer Burden

Age-standardized incidence rate - breast
Region Age-standardized Rate
Japan 57.6
Canada 83.8
United States 84.9
Norway 87.5
Ontario 89.0
Finland 89.5
Sweden 89.8
New Zealand 92.6
United Kingdom 93.6
France 99.1
Netherlands 105.9

Source: World Health Organization [Internet]. Geneva: World Health Organization; c2019. GLOBOCAN 2018: estimated cancer incidence, mortality and prevalence worldwide in 2018; [cited on 2019 Apr 10]. Available from: http://globocan.iarc.fr

Age-standardized mortality rate - breast
Region Age-standardized Rate
Japan 9.3
Norway 11.0
Finland 11.3
Sweden 11.4
Canada 12.1
United States 12.7
Ontario 13.0
New Zealand 14.2
United Kingdom 14.4
France 15.4
Netherlands 16.5

Source: World Health Organization [Internet]. Geneva: World Health Organization; c2019. GLOBOCAN 2018: estimated cancer incidence, mortality and prevalence worldwide in 2018 [cited on 2019 Apr 10]. Available from: http://globocan.iarc.fr

Five-year relative survival ratio
Region Percentage (%)
Nova Scotia 86.7
Saskatchewan 87.2
British Columbia 87.4
New Brunswick 87.4
Manitoba 88.0
Prince Edward Island 88.3
Ontario 88.5
Alberta 88.8

Source: North American Association of Central Cancer Registries [Internet].Cancer in North America: 2012-2016, Volume Four: Cancer Survival in the United States and Canada 2009-2015; [cited on 2019 Sept 10]. Available from: https://www.naaccr.org/wp-content/uploads/2019/05/CINA2018.v4.survival.pdf

Screening

Screening participation
Region Percentage (%)
BC 53.0
Australia 54.0
Quebec 62.0
Ontario 65.0
England 75.0

Source:

  • Ontario Health Insurance Plan (OHIP) Claims History Database (CHDB), Integrated Client Management System (ICMS), Ontario Cancer Registry (OCR), Ontario Registered Persons Database (RPDB), Postal Code Conversion File Plus (PCCF+ version 6D)
  • Australian Institute of Health and Welfare. (2019). BreastScreen Australia monitoring report 2019. Canberra: AIHW.
  • National Health Service. (2019). Breast Screening Programme England, 2017-18. England, UK: Screening & Immunisations Team, NHS Digital.
  • BC Cancer Provincial Health Services Authority. (2018). BC Cancer Breast Screening 2017 Program Results. Vancouver: BC Cancer Breast Screening Provincial Health Services Authority.
  • Canadian Partnership Against Cancer. (2017). Breast Cancer Screening in Canada: Monitoring and Evaluation of Quality Indicators - Results Report, January 2011 - December 2012. Toronto: Canadian Partnership Against Cancer.
     

Diagnosis

Stage distribution: stage 1
Region Percentage (%)
Norway 41.5
Ontario 43.8

Source:

  • Ontario Cancer Registry, February 2019
  • The Cancer Registry of Norway and its annual publication, Cancer in Norway 2017, summarizes the national cancer statistics.

 

Colorectal Cancer Indicators With Jurisdictional Comparators<br />

Source: See Data Tables tab for source information.

Notes:

  1. Excludes modifiable risk factors.
  2. Left arrow means desired direction is down. Right arrow means desired direction is up.

Data Table 3: Colorectal Cancer Indicators With Jurisdictional Comparators

Cancer Burden

Age-standardized incidence rate - colorectal
Region Age-standardized Rate
Finland 24.6
United States 25.6
Sweden 26.9
France 30.4
Canada 31.5
United Kingdom 32.1
Ontario 32.4
New Zealand 35.3
Netherlands 37.8
Japan 38.9
Norway 42.9

Source: World Health Organization [Internet]. Geneva: World Health Organization; c2019. GLOBOCAN 2018: estimated cancer incidence, mortality and prevalence worldwide in 2018; [cited on 2019 Apr 10]. Available from: http://globocan.iarc.fr
 

Age-standardized mortality rate - colorectal (male)
Region Age-standardized Rate
United States 9.6
Finland 10.8
Ontario 11.6
Canada 12.2
Sweden 12.4
France 13.1
United Kingdom 13.3
New Zealand 13.4
Japan 15.2
Norway 15.3
Netherlands 16.5

Source: World Health Organization [Internet]. Geneva: World Health Organization; c2019. GLOBOCAN 2018: estimated cancer incidence, mortality and prevalence worldwide in 2018 [cited on 2019 Apr 10]. Available from: http://globocan.iarc.fr
 

Age-standardized mortality rate - colorectal (female)
Region Age-standardized Rate
Finland 6.8
United States 6.9
Ontario 7.8
France 7.9
Canada 8.2
Sweden 9.0
Japan 9.2
United Kingdom 9.3
New Zealand 10.9
Norway 11.3
Netherlands 11.5

Source: World Health Organization [Internet]. Geneva: World Health Organization; c2019. GLOBOCAN 2018: estimated cancer incidence, mortality and prevalence worldwide in 2018 [cited on 2019 Apr 10]. Available from: http://globocan.iarc.fr
 

Five-year relative survival ratio
Region Percentage (%)
Prince Edward Island 61.1
Nova Scotia 63.3
Manitoba 65.2
Alberta 65.7
British Columbia 66.1
New Brunswick 66.7
Saskatchewan 66.9
Ontario 68.6

Source: North American Association of Central Cancer Registries [Internet].Cancer in North America: 2012-2016, Volume Four: Cancer Survival in the United States and Canada 2009-2015; [cited on 2019 Sept 10]. Available from: https://www.naaccr.org/wp-content/uploads/2019/05/CINA2018.v4.survival.pdf
 

Screening

Overdue for screening
Region Percentage (%)
Ontario 38.0
Manitoba 50.0
Australia 59.0

Source:

  • Ontario Health Insurance Plan (OHIP) Claims History Database (CHDB), Lab Reporting Tool (LRT), Colonoscopy Interim Reporting Tool (CIRT), GI Endo Data Submission Portal (DSP), Ontario Cancer Registry (OCR), Ontario Registered Persons Database (RPDB), Postal Code Conversion File Plus (PCCF+ version 6D)
  • Canadian Partnership Against Cancer. Colorectal Cancer Screening in Canada: Monitoring & Evaluation of Quality Indicators – Results Report, January 2011 – December 2012. Toronto: Canadian Partnership Against Cancer, 2014
  • CancerCare Manitoba. (n.d.). Colorectal Cancer Screening Report January 2011- December 2012. Winnipeg, MB: ColonCheck CancerCare Manitoba. 
  • Australian Institute of Health and Welfare. (2019). National Bowel Cancer Screening Program: monitoring report 2019. Canberra: AIHW.
Perforation during colonoscopies (per 1,000)
Region Perforations per 1,000 Colonoscopies
Ontario 0.4
England 0.6

Source:

  • Ontario Health Insurance Plan (OHIP) Claims History Database (CHDB), Canadian Institute for Health Information (CIHI) Discharge Abstract Database (DAD)/National Ambulatory Care Reporting System (NACRS), Ontario Cancer Registry (OCR), Ontario Registered Persons Database (RPDB), Postal Code Conversion File Plus (PCCF+ version 6D)
  • Derbyshire, E., Hungin, P., Nickerson, C., & Rutter, M. D. (2018). Colonoscopic perforations in the English national health service bowel cancer screening programme. Endoscopy50(09), 861-870.
     

Diagnosis

Stage distribution: stage 1
Region Percentage (%)
Norway 20.4
Ontario 24.6

Source:

  • Ontario Cancer Registry, February 2019
  • The Cancer Registry of Norway and its annual publication, Cancer in Norway 2017, summarizes the national cancer statistics.

Treatment

Rectal surgery resection reports with involved (positive) circumferential radial margins (%)
Region Percentage (%)
Ontario 7.3
Scotland 6.0

Source:

Colon cancer surgery reports with 12 or more nodes examined (%)
Region Percentage (%)
Nova Scotia 71.0
Prince Edward Island 74.0
Saskatchewan 75.0
Alberta 79.0
New Brunswick 84.0
Scotland 89.0
Newfoundland 90.0
Manitoba 91.0
Ontario 94.0

Source:

Lung Cancer Indicators With Jurisdictional Comparators<br />

Source: See Data Tables tab for source information.

Notes:

  1. Excludes modifiable risk factors.
  2. Left arrow means desired direction is down. Right arrow means desired direction is up.

Data Table 4: Lung Cancer Indicators With Jurisdictional Comparators

Cancer Burden

Age-standardized incidence rate - lung
Region Age-standardized rate (per 100,000)
Sweden 17.4
Finland 19.3
New Zealand 25.3
Japan 27.5
Norway 29.9
Canada 30.0
United Kingdom 32.5
Netherlands 33.3
Ontario 33.3
United States 35.1
France 36.1

Source: World Health Organization [Internet]. Geneva: World Health Organization; c2019. GLOBOCAN 2018: estimated cancer incidence, mortality and prevalence worldwide in 2018; [cited on 2019 Apr 10]. Available from: http://globocan.iarc.fr
 

Age-standardized mortality rate - lung, men
Region Age-standardized rate (per 100,000)
Sweden 15.0
New Zealand 18.5
Finland 20.8
Norway 22.3
Ontario 23.9
United Kingdom 25.2
Canada 25.4
United States 25.9
Japan 26.5
Netherlands 29.7
France 38.9

Source: World Health Organization [Internet]. Geneva: World Health Organization; c2019. GLOBOCAN 2018: estimated cancer incidence, mortality and prevalence worldwide in 2018 [cited on 2019 Apr 10]. Available from: http://globocan.iarc.fr
 

Age-standardized mortality rate - lung, women
Region Age-standardized rate (per 100,000)
Japan 7.8
Finland 11.2
Sweden 14.8
France 15.3
New Zealand 17.8
Norway 18.6
United States 19.0
Ontario 19.3
United Kingdom 19.7
Canada 22.1
Netherlands 24.5

Source: World Health Organization [Internet]. Geneva: World Health Organization; c2019. GLOBOCAN 2018: estimated cancer incidence, mortality and prevalence worldwide in 2018 [cited on 2019 Apr 10]. Available from: http://globocan.iarc.fr
 

Five-year relative survival ratio
Region Percentage (%)
Prince Edward Island 14.0
Nova Scotia 18.4
Saskatchewan 19.6
British Columbia 20.7
Alberta 20.7
Manitoba 21.6
New Brunswick 23.5
Ontario 24.4

Source: North American Association of Central Cancer Registries [Internet].Cancer in North America: 2012-2016, Volume Four: Cancer Survival in the United States and Canada 2009-2015; [cited on 2019 Sept 10]. Available from: https://www.naaccr.org/wp-content/uploads/2019/05/CINA2018.v4.survival.pdf
 

Diagnosis

Stage distribution: stage I
Region Percentage (%)
Ontario 24.2
Norway 18.0

Source:

  • Ontario Cancer Registry, February 2019
  • The Cancer Registry of Norway and its annual publication, Cancer in Norway 2017, summarizes the national cancer statistics.

Treatment

NSCLC patients who had PET/CT scan prior to radical treatment
Region Percentage (%)
Ontario 85.0
Scotland 97.5

Source:

  • Ontario Cancer Registry, Ontario Registered Persons Database (RPDB), Cancer Activity Level Reporting (ALR), Canadian Institute for Health Information’s Discharge Abstract Database (CIHI-DAD), Canadian Institute for Health Information’s National Ambulatory Care Reporting System (CIHI-NACRS), Ontario Health Insurance Plan (OHIP)
  • National Services Scotland. Lung Cancer Quality Performance Indicators [Internet]. 2017 [cited 2019 April 05]. Available from https://www.isdscotland.org/Health-Topics/Quality-Indicators/Publications/2017-02-28/2017-02-28-Lung-QPI-Report.pdf
Post-surgery mortality
Region 90 day 30 day
Ontario 3.2 1.5
Scotland 3.9 1.5

Source:

 

Prostate Cancer Indicators With Jurisdictional Comparators<br />

Source: See Data Tables tab for source information.

Notes:

  1. Excludes modifiable risk factors.
  2. Left arrow means desired direction is down. Right arrow means desired direction is up.

Data Table 5: Prostate Cancer Indicators With Jurisdictional Comparators

Cancer Burden

Age-standardized incidence rate - prostate
Region Age-standardized Rate (per 100,000)
Japan 35.4
Canada 58.2
Ontario 64.3
Netherlands 68.9
Finland 71.6
United States 75.7
United Kingdom 80.7
New Zealand 90.8
France 99.0
Sweden 103.0
Norway 106.5

Source: World Health Organization [Internet]. Geneva: World Health Organization; c2019. GLOBOCAN 2018: estimated cancer incidence, mortality and prevalence worldwide in 2018; [cited on 2019 Apr 10]. Available from: http://globocan.iarc.fr
 

Age-standardized mortality rate - prostate
Region Age-standardized Rate (per 100,000)
Japan 4.4
United States 7.7
Canada 7.8
France 8.1
Ontario 8.7
Finland 10.8
New Zealand 11.6
Netherlands 11.7
United Kingdom 12.7
Sweden 15.0
Norway 16.1

Source: World Health Organization [Internet]. Geneva: World Health Organization; c2019. GLOBOCAN 2018: estimated cancer incidence, mortality and prevalence worldwide in 2018 [cited on 2019 Apr 10]. Available from: http://globocan.iarc.fr
 

Five-year relative survival ratio
Region Percentage (%)
Saskatchewan 89.9
Manitoba 90.8
Alberta 91.5
Prince Edward Island 92.3
British Columbia 92.5
Ontario 93.1
Nova Scotia 93.1
New Brunswick 93.4

Source: North American Association of Central Cancer Registries [Internet].Cancer in North America: 2012-2016, Volume Four: Cancer Survival in the United States and Canada 2009-2015; [cited on 2019 Sept 10]. Available from: https://www.naaccr.org/wp-content/uploads/2019/05/CINA2018.v4.survival.pdf
 

Diagnosis

Stage distribution: stage I
Region Percentage (%)
Scotland 17.0
Northern Ireland 21.0
Ontario 23.8
England 30.0

Source:

Treatment

Low-risk localized prostate cancer patients who received no treatment
Region Percentage (%)
Alberta 41.5
Nova Scotia 42.9
British Columbia 46.7
Saskatchewan 48.7
Manitoba 73.7
Prince Edward Island 76.4
Ontario 81.1

Source:

Positive margins following radical prostatectomy
Region Percentage (%)
Scotland 20.0
Ontario 20.5

Source: