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Objective: To examine differences in fee-for-service (FFS) payments to men and women radiologists in Canada and evaluate potential contributors. Methods: Publicly available FFS radiology billing data was analyzed from British Columbia (BC), Ontario (ON), Prince-Edward Island (PEI) and Nova Scotia (NS) between 2017 and 2021. Data was analyzed by gender on a per-province and national level. Variables evaluated included year, province, procedure billings, and days worked (BC and ON only). The gender pay gap was expressed as the difference in mean billing payments between men and women divided by mean payments to men. Results: Data points from 8478 radiologist years were included (2474 [29%] women and 6004 [71%] men). The unadjusted difference in annual FFS billings between men and women was $126,657. Overall, payments to women were 81% of payments to men with a 19% gender pay gap. The difference in billings between men and women did not change significantly between 2017 and 2021 (range in gender pay gap, 17–21%) but did vary by province (highest gap NS). Compared to men, women worked fewer days per year (weighted mean 218 ± 29 vs 236 ± 25 days/year, P <.001, 8% difference). Conclusion: In an analysis of fee-for-service payments to radiologists in 4 Canadian provinces between 2017 and 2021, payments to women were 81% of payments to men with a 19% gender pay gap. Payments were lower to women across all years evaluated. Women worked 8% fewer days per year on average than men, which did not fully account for the difference in FFS billing payments between men and women. Summary Statement: In an analysis of fee-for-service payments to Canadian radiologists between 2017 and 2021, payments to women were 81% of payments to men with a 19% gender pay gap which is not fully accounted for by time spent working. Visual Abstract [ABSTRACT FROM AUTHOR]

Purpose: Administrative health data can be a valuable resource for health research. Because these data are not collected for research purposes, it is imperative that the accuracy of codes used to identify patients, exposures, and outcomes is measured. Patients and Methods: Code sensitivity was determined by identifying a cohort of men with histologically confirmed prostate cancer in the Ontario Cancer Registry and linking them to the Ontario Health Insurance Plan (OHIP) to determine whether a prostate biopsy code had been claimed. Code specificity was estimated using a random sample of patients at The Ottawa Hospital for whom a prostate biopsy code was submitted to OHIP. A simulation model, which varied the code false-positive rate, true-negative rate, and proportion of code positives in the population, was created to determine specificity under a range of combinations of these parameters. Results: Between 1991 and 2012, 97,369 of 148,669 men with histologically confirmed prostate cancer in the Ontario Cancer Registry had a prostate biopsy code in OHIP within 1 week of their diagnosis (code sensitivity, 86.0%). This increased significantly over time (63.8% in 1991 to 87.9% in 2012). The false-positive rate of the code for index prostate biopsies was 1.9%. The simulation model found that the code specificity exceeded 95% for first prostate biopsy but was lower for secondary biopsies because of more false positives. False positives primarily were related to placement of fiducial markers for patients who received radiotherapy. Conclusion: Administrative data in Ontario can accurately identify men who receive a prostate biopsy. The code is less accurate for secondary biopsy procedures and their sequelae. [ABSTRACT FROM AUTHOR]

Colorectal cancer (CRC) is the most common cause of cancer death among Canadian non-smokers. Each year about 21 500 Canadians are diagnosed with CRC. Ninety percent of cases occur in people aged 50 years or older. An estimated 4800 Canadian men and 4100 Canadian women die each year from the disease.1 About 75% of all new CRC cases arise in people with no known risk factors.2 Computed tomography colonography (CTC), a cross-sectional imaging examination that permits complete structural examination of the colon, shows promise as a tool for CRC screening. This article reviews the rationale for CRC screening, currently recommended Canadian and American screening guidelines and screening tools, and current evidence supporting CTC as a CRC screening tool and its advantages over conventional screening methods. [ABSTRACT FROM AUTHOR]

Colon cancer is the third most common malignancy in Canada. Computed tomography colonography (CTC) provides a creditable and validated option for colon screening and assessment of known pathology in patients for whom conventional colonoscopy is contraindicated or where patients self-select to use imaging as their primary modality for initial colonic assessment. This updated guideline aims to provide a toolkit for both experienced imagers (and technologists) and for those considering launching this examination in their practice. There is guidance for reporting, optimal exam preparation, tips for problem solving to attain high quality examinations in challenging scenarios as well as suggestions for ongoing maintenance of competence. We also provide insight into the role of artificial intelligence and the utility of CTC in tumour staging of colorectal cancer. The appendices provide more detailed guidance into bowel preparation and reporting templates as well as useful information on polyp stratification and management strategies. Reading this guideline should equip the reader with the knowledge base to perform colonography but also provide an unbiased overview of its role in colon screening compared with other screening options. [ABSTRACT FROM AUTHOR]