Research Projects
The CPRC will share upcoming, current, and past research activities that our cluster members are involed in here.
HEALthy Eating and Supportive Environments (HEAL); A Pan-Canadian Study
Principal Investigators: Rachel Murphy*, Sharon Kirkpatrick, Jennifer Vena
Co-Investigators: Phillip Awadalla*, Parveen Bhatti, Jeffrey Brook*, Trevor Dummer*, Guy Faulkner, Benoit Lamarche, Leia Minaker, Nancy Ross, Michael Windener
* = CPRC Member
Most Canadians do not consume diets that align with health recommendations. As a result, poor diet is among the leading causes of chronic diseases like cancer, heart disease, and diabetes in Canada. The environment where people live, work and play is increasingly recognized as an important factor shaping dietary intake, and is potentially modifiable. However, in order to drive meaningful improvements in the dietary intake of Canadians, we need to gain a better understanding of how environments support healthy eating. The aims of this project are to 1) describe how dietary intake is linked with aspects of the food environment like how accessible healthy foods are within communities, provinces and across Canada, 2) examine how links between dietary intake and the food environment group with other environmental factors like how walkable a neighbourhood is and factors known to influence chronic disease risk such as physical activity, income and education. To accomplish these aims, we will collect data on diet, physical activity and other health factors with user-friendly online tools in a large study of men and women across 8 provinces; the Canadian Partnership for Tomorrow Project (CanPath) and connect with NutriQuébec, an ongoing cohort collecting similar data. CanPath and NutriQuébec, are linked to nation-wide environment data including measures of the food, social and built environments, creating a rich data source to explore our novel research questions. This study will contribute critical evidence that may help support approaches to improve the dietary intake of Canadians.
The Environment and Lung Cancer
Principal Investigators: Stephen Lam*, William Lockwood*
Co-Investigators: Wan Lam*, Renelle Myers, Rafael Meza*, Trevor Dummer*, Calum MacAulay, Martin Tammemagi
* = CPRC Member
In 2022, an estimated 30,000 people were diagnosed with lung cancer in Canada, making it the most diagnosed cancer in the country. It was also responsible for one in four cancer-related deaths, making it the deadliest cancer in the country.
In the past, smoking has been the leading cause of lung cancer, but that may soon change. In fact, even though lung cancer rates in Canada are generally declining alongside smoking rates, lung cancer rates among people who have not smoked a cigarette in their life are increasing. As this dangerous trend becomes more apparent, researchers are shifting their focus toward its most likely culprit: air pollution.
To address this emerging issue, Drs. Stephen Lam, distinguished scientist at BC Cancer and professor of medicine at the University of British Columbia (UBC), and William Lockwood, senior scientist at BC Cancer and assistant professor (pathology and laboratory medicine) at UBC, will co-lead a team of experts in a new Terry Fox New Frontiers Program Project seeking to improve the prevention, detection and treatment of lung cancer among individuals who have never smoked but may be at high risk due to exposure to air pollution.
“With a growing and urbanizing world population and climate change, this program project addresses an urgent need to better understand how our environment impacts lung cancer development and progression,” says Dr. Lam. “We will use the funds to assemble a multi-disciplinary team of experts to study the effects of outdoor air pollutants and identify how they cause damage and promote the development of lung cancer in people who have never smoked. This in turn will allow us to develop interventions to detect and prevent lung cancer at an early stage and treat more effectively.”
The team, which has long been supported by the TFRI, will receive $2.4 million over four years to use multi-ethnic datasets from around the world to build a lung cancer risk prediction model for non-smokers, which could help identify high-risk individuals and inform future screening protocols for at-risk groups.
As part of the project, they will also identify changes in the lung microbiome – the collection of bacteria that live within our lungs – to create an innovative, non-invasive breath test for early lung cancer detection.
“Previous support by the Terry Fox Research Institute enabled us to do the research and translate the findings to implement lung cancer screening programs across Canada for people who have smoked heavily in the past. In fact, the knowledge we gained from the previous grant is already benefitting lung cancer patients around the world today with CT scan screening shown to reduce lung cancer mortality by more than 20 per cent,” explains Dr. Lam. “It is our hope that findings from this new team grant will expand the benefits of early detection and prevention to a wider population by including those who have never smoked.”
Funding for this new New Frontiers Program Project Grant in The Environment and Lung Cancer is provided equally by the Terry Fox Foundation and the Lotte & John Hecht Memorial Foundation.
Combating Online Misinformation About Cancer Causes and Prevention
Principal Investigator: Cheryl Peters*
* = CPRC Member
A team led by Dr. Cheryl Peters is investigating how people in Canada get cancer prevention information online, helping them access evidence-based, reliable information. Cancer is the leading cause of death in Canada and some cancers are preventable through lifestyle modifications such as smoking cessation, maintaining a healthy weight and moderating alcohol intake. But misinformation about what increases the risk of cancer is very common online, including on social media platforms. Understanding how and why this misinformation spreads is key to reducing it and providing people in Canada with evidence-based reliable information about cancer prevention.
With funding from the Canadian Cancer Society, a team led by Dr. Peters' team is learning more about why misinformation about cancer prevention is so prevalent online. The researchers will conduct focus groups to find out more about how people in Canada access and understand information about cancer prevention. The team will survey social media platforms and online stores to analyze information and misinformation about cancer prevention. They will also develop an innovative digital strategy to improve people’s health literacy about cancer prevention based on the results of this analysis.
This project will provide new information about how people in Canada access information on cancer prevention and ways to counter misinformation online, empowering people to make informed lifestyle choices and decrease their cancer risk based on the best possible evidence-based information.
Changing the Narrative of Lung Cancer to Improve Prevention for Non-Smokers
Principal Investigators: R Urquhart* (Nominated PI); Co-PIs: G Dellaire, T Dummer*, A Goodarzi, G Maksym, M Aristizabal, V Martinez, A Wallace
Co-Investigators: J Boudreau, B Jonhston, C Kendell, JS Kim, S Lam*, W Lam*, D Manos, P Murphy, N Saint-Jacques, S Snow, Z Xu
* = CPRC Member
Lung cancer is most often linked to smoking. But due to exposure to cancer-causing substances such as arsenic, radon gas and air pollution, lung cancer can also occur in people who have never smoked. Yet, in several provinces in Canada where screening programs are being implemented for people at high-risk of lung cancer, only a person’s age and smoking history are currently considered in the risk assessment.
With funding from the Canadian Cancer Society, this research team is working to make sure environmental factors are considered when assessing a person’s risk of lung cancer. Using state-of-the-art infrastructure and employing expertise and patient experience from across Canada, the team aims to identify biological markers of risk related to arsenic, radon and air pollution and develop a monitoring system for air pollution (specifically tiny particles called PM2.5) to better understand how it affects our cells and elevates cancer risk. They will also explore how best to communicate and raise awareness about these risks and influence lung cancer screening programs.
The results of this research will provide actionable information around environmental exposures to improve personalized lung cancer risk assessment, inform screening criteria and programs and improve lung cancer early detection efforts across Canada.
Identifying Opportunities to Prevent Cancer in Atlantic Canada
Principal Investigator: N Saint-Jacques, T Dummer*
Co-Investigators: D Brenner, P Brown, D Dutton, C Fend, J McDonald, D Rainham, R Urquhart*
* = CPRC Member
Dr. Nathalie Saint-Jacques is looking for ways to reduce cancer risk in Atlantic Canada, where cancer incidence rates are among the highest in the country. Supported by an Atlantic Canada Research Grant, Dr. Saint-Jacques and her team are mapping communities in all 4 Atlantic provinces with higher-than-average cancer rates. Through their work, the team will estimate the number and type of cancers that could be prevented in these communities through risk-reducing behaviours and identify community-level prevention and support efforts. The first study in Canada to assess community-specific cancer burden to identify and prioritize prevention strategies, this research has the potential to reduce cancer rates and improve health for people in Atlantic Canada.
Preparing for the Recovery from the Effects of the PAndemic on Cancer Control Using Real-World Evidence in Canada (PREPARE-Canada)
Principal Investigators: P Awadalla*, S Abelson, R Alvi, P Bhatti, P Broet, T Dummer, V Kirsh, JR Mclaughlin, G Shen-Tu, E Sweeney, D Turner, R Urquhart
Co-Investigators: JE Dick, K Skead
* = CPRC Member
The global burden of cancer is a major public health crisis that has been deeply exacerbated by the COVID-19 pandemic. Since the World Health Organization declared COVID-19 a pandemic on March 11 2020, provinces across Canada have undergone varying degrees of cyclical lockdowns. Many provinces have canceled or delayed scheduled surgeries and ceased non-essential clinical activity, including essential cancer screening and care activities. As a result of missed screening appointments, many cancers will only be captured at a much later stage when treatments are less likely to be effective. The benefits of early detection are of paramount importance to outcomes at the patient level, and are associated with significantly less burden placed on the healthcare system which translates into economic benefits. The effects of the pandemic will be felt for many years and health system capacity will remain under pressure due to the balancing act between COVID-19 care, disease incidence and a wave of demand stemming from delayed, and likely more severe, diagnostic outcomes and treatment requirements. To equip the healthcare system to plan for the future demand, it is essential that we capture the impact of COVID-19 on cancer outcomes in Canada, as well as the impact of COVID-19 on modifying cancer risk in the general population. Here, we will take advantage of the Canadian Partnership for Tomorrow's Health (CanPath), the largest population health study in Canada's history, to capture the effects of the pandemic on patterns of cancer diagnoses across Canada and access to services. We will study how the pandemic has impacted demand for cancer services at a population level and will also capture how COVID-19 infection changes cancer risk at the individual level. These insights will be used to predict the burden of cancer in the coming years which will directly inform the cancer control strategies in a post-pandemic Canada.
Preventing Ovarian Cancer By Removing The Fallopian Tubes Of People Who Have Finished Childbearing
Principal Investigator: G Hanley*
* = CPRC Member
Dr. Gillian Hanley is investigating whether fallopian tube removal during colorectal surgery is safe and cost-effective. Ovarian cancer was the cause of about 1,950 deaths in Canada in 2020. Despite this, there is no routine effective screening method to detect ovarian cancer and no significant treatment advances have been made in the past 30 years. People in British Columbia who have had their fallopian tubes removed during gynecological surgeries such as hysterectomies have not reported a single case of high-grade ovarian cancer. This procedure has proven to be safe and effective. With funding from the Canadian Cancer Society, Dr. Hanley will work with surgeons in Vancouver to offer the removal of fallopian tubes to people who have finished childbearing and who are already undergoing colorectal surgery to remove growths. The researchers will evaluate whether the operation is successful in people who do opt to have their fallopian tubes removed during colorectal surgery and if this causes any extra complications. They will also determine how much extra time this optional procedure takes and whether the procedure is cost-effective, with the aim of offering it to more people undergoing colorectal surgery. If successful and widely implemented, this procedure will prevent ovarian cancer in more people.
Indigenous and Tribal Peoples and Cancer
Primary Author: Gail Garvey
Additional Authors: Peter Hutchinson*
* = CPRC Member
Although cancer survival has improved markedly in developed countries in recent decades, not all groups have benefited equally. In particular, Indigenous and Tribal peoples continue to have poorer cancer outcomes than their non-Indigenous counterparts. The available evidence suggests these disparities are linked to a complex combination of factors, including higher incidence of cancers associated with a high case fatality, later stage of diagnosis, reduced access to cancer treatment, and poorer overall health. Much research is underway to explore approaches to improving health system responses for Indigenous and Tribal peoples. A developing evidence base is supporting effective translation of knowledge into practice. This book offers a global perspective on this evidence base, written from Indigenous perspectives.
This book is the first comprehensive publication to report on cancer incidence, mortality, prevalence, survival, and inequities for Indigenous and Tribal peoples globally, with the aim of enhancing global efforts to improve outcomes for these populations. Its content and approach are led by Indigenous researchers with international reputations in health and cancer research. Chapters provide important information and data to support Indigenous-specific, targeted cancer awareness and early detection campaigns. This book goes beyond a discussion of the issues and challenges in Indigenous health, with a strengths-based approach to discussing successful health interventions, research projects, research translation, and living well – both with and beyond cancer.