Cancer Mortality in First Nations Peoples in Ontario Methodology

Cancer Mortality in First Nations Peoples in Ontario
Short description of Indicator	Age-standardized mortality rate: the number of deaths from cancer among First Nations peoples that would occur in a specified population if it had the same age-distribution as a given standard population, per 100,000 population, during a defined time period.
Rationale for measurement	Monitoring cancer mortality allows us to measure and evaluate population-level progress of cancer control efforts, including prevention, early detection (i.e., screening) and treatment, in reducing deaths due to cancer. It can also assist in predicting future cancer mortality rates and trends to help plan for upcoming resource, policy and research needs.
Evidence/references for rationale	This is a well-established cancer burden indicator, described and reported on by numerous provincial, national and international organizations, including: The International Agency for Research on Cancer (IARC) and the World Health Organization (WHO). See http://www-dep.iarc.fr/WHOdb/WHOdb.htm . The United States' National Cancer Institute. See http://surveillance.cancer.gov/statistics/types/mortality.html . Statistics Canada, the Public Health Agency of Canada (PHAC), and the Canadian Cancer Society. See http://www.cancer.ca/en/cancer-information/cancer-101/canadian-cancer-statistics-publication/?region=on . The Canadian Partnership Against Cancer (CPAC). See http://www.systemperformance.ca/
Calculations for the indicator	Age-standardized mortality rate: (SUM(age-specific mortality rate in a given age group x standard population in that age group) / (total population in the standard population)) x 100,000 Analysis: Breast cancer was only examined among females For all cancers (ICD-10 codes: C00–C97), cancer of the female breast (C50), colorectal (C18-C20, C26.0), lung (C34), prostate (C61) ,by sex, Ontario, 1991-2010. Rates were standardized using the 1960 World Standard population as the standard population.
Standardized Rate Calculation	Rates were standardized using the 1960 World Standard population as the standard population.
Unit	N/A
Data sources	Ontario Cancer Registry, (Cancer Care Ontario) Population data: Registered Persons Database (RPDB) and Indian Registration System (IRS) from Institute for Clinical Evaluative Sciences The IRS was linked to the RPDB to identify First Nations people in Ontario. This linked file was then linked to OCR to identify First Nations in Ontario with a cancer diagnosis between 1991 and 2010.
Time Frame	1991-2010
Geographic Scale	Provincial
Denominator description	N/A
Numerator description	N/A
Considerations	The use of a standard population allows mortality rates to be compared across time periods and jurisdictions by adjusting for differences in the population age distribution over time and across geographic areas. Cancers were defined using Surveillance, Epidemiology and End Results (SEER) Cause of Death Recode definitions: http://www.seer.cancer.gov/codrecode/1969+_d04162012/index.html. Cancer definitions using SEER Recode may differ from definitions in other published analyses.
Data availability & limitations	IRS only includes Registered First Nations; therefore, this analysis does not include non-Registered First Nations in Ontario.