Equity-focused interventions to increase colorectal cancer screening

Definitions of key terms

These definitions are based on terms used by Statistics Canada, the Canadian Community Health Survey (CCHS) and other data sources referenced in this report. 

Equity 

Equity is the practice of ensuring fair, inclusive and respectful treatment of all people, with consideration of individual and group diversity—which doesn’t necessarily mean treating all individuals in exactly the same way. Equity honours and accommodates the specific needs of individuals and groups. 

Geographic regions 

• Urban refers to census metropolitan areas with core populations of 10,000 people or more. 
• Rural refers to census subdivisions outside urban areas with populations of less than 10,000 people and where at least 30% of the employed labour force commutes to urban areas for work. 
• Rural/remote refers to census subdivisions outside urban areas with populations of less than 10,000 people and where at least 5% of the employed labour force commutes to urban areas for work. 
• Rural/very remote refers to census subdivisions outside urban areas with populations of less than 10,000 people and where less than 5% of the employed labour force commutes to urban areas for work. Non-urban parts of the territories are also included in this category. 

Minority and immigrant groups 

• Ethnic origin is the ethnic or cultural groups to which a person’s ancestors belonged. 
• Visible minorities are people, other than First Nations, Inuit and Métis peoples, who are not white. 
• Immigrants are people who are or who have ever been landed immigrants or permanent residents. Immigrants who have obtained Canadian citizenship by naturalization are included in this group. 
• Immigrant status is reported using three categories: Canadian-born, in Canada for less than 10 years, in Canada for 10 years or more. 
• Immigrant density is a percentage calculated as the number of immigrant and non-permanent residents living in a specific area, divided by the area’s total population. 

Income and socioeconomic status 

• Income is measured based on earnings, including from government sources such as social assistance, child benefits, employment insurance and pensions. 
• Canadians are grouped in one of five income quintiles based on household or neighbourhood income. The lowest income quintile represents the one-fifth of households with the lowest income, while the highest income quintile comprises the one-fifth of households with the highest income. 
• Low-income threshold is the adjusted ratio of total household income to the low-income cut-off for a person’s household and community size. 

Disability 

• Disabilities are physical, mental, intellectual or sensory impairments which, in interaction with various barriers, may hinder a person’s full and effective participation in society on an equal basis with others. 

Screening 

• Provincial and territorial organized colorectal cancer screening programs are available in Canada to people who show no signs or symptoms of colorectal cancer and are at average risk for colorectal cancer. These programs use recruitment, reminder and promotional strategies to invite eligible people to screen. 
• A fecal test checks for hidden blood in the stool, which may be a sign of colorectal cancer or other problems, such as polyps, ulcers or hemorrhoids. 
• Participation rate is the percentage of the eligible population who successfully completed a fecal test in an organized cancer screening program within a two-year period. 
• Up-to-dateness is a measure of how recently people have completed a fecal test. People are considered up-to-date for colorectal cancer screening when they have completed a fecal test within the past two years, a sigmoidoscopy within the past 10 years and/or a colonoscopy within the past 10 years. 
• Usual care is the level of care a person receives under normal circumstances, when no specific intervention has been implemented. By comparing the results of usual care to the results of an intervention, the effectiveness of that intervention can be measured.