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Methodology 1.1.b

Cancer in Ontario Methodology
Short description of Indicator Age-standardized mortality rate: the number of deaths from cancer 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:
Calculations for the indicator
  1. Age-standardized mortality rate:
    [(∑ age – specific mortality rate in a given age group x standard popn in that age group)/(total population in the standard population)] x 100,000

    Analysis:
    • For all cancers (ICD-10 codes: C00–C97), cancer of the female breast (C50), colorectal (C18-C20, C26.0), lung (C34), prostate (C61) and bladder (C67), by sex, Ontario, 1981‒2013.
      • Rates were standardized using 5-year age groups with the 2011 Canadian population as the standard population.
      • All deaths among Ontario residents who died in Ontario were included.
  2. Cancer death projection:
    • Details on projection method for Ontario
      • All cancer deaths from 1983-2012 were grouped by 5-year age groups and time periods, with both sexes combined. Population data was also similarly aggregated.
      • NORDPRED (https://www.kreftregisteret.no/en/Research/Projects/Nordpred/Nordpred-software/) was used to predict cancer incidence from 2013 to 2032, in four 5-year periods.
      • Linear interpolation was used to create annual counts for 2013 to 2029.
    • Details on projection method for LHINs
      • The steps outlined above for Ontario were re-run for each LHIN. Unlike previous LHIN projections, true LHIN-specific projections were modelled.

A final year- and age-specific scaling step was added to adjust the LHIN projections so that they now add to the initial Ontario projections.

Standardized Rate Calculation Rates were standardized using 5-year age groups with the 2011 Canadian population as the standard population.
Unit N/A
Data sources
  • Ontario Cancer Registry, 2016 (Cancer Care Ontario)
  • Population data: Ontario Ministry of Finance. Ontario Population Projections (based on the 2011 Census released by Statistics Canada February 2015). Spring 2016 release.
  • LHIN population data: Ontario Ministry of Finance. Ontario LHIN Population Projections. Spring 2016 release.
Time Frame 1981-2013
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. The 2011 Canadian population standard is specified by Statistics Canada.
  • 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
  • Mortality rates were calculated through 2013, the most recent year for which the Ontario Cancer Registry had received complete data at the time of analysis.
  • Projected estimates were calculated for 2014 through 2018.
CSQI Year 2018