For Researchers
Research Approved to Access OHS Data and Biosamples
Research made possible through the OHS platform
Since 2012, the OHS has supported dozens of studies on a variety of topics, looking at the early onset of breast cancer, lung cancer in non-smokers, cardiovascular disease, mental health issues, and the impact of access to greenspace on various health outcomes, to name a few.
Jump to the list of all approved projects
Here is a breakdown of approved projects by area of study:
Featured Research Findings
Here are a few examples of findings from research projects that used OHS data and or biosamples.
- Low body mass index, high waist circumference, lower parity, and familial history of breast cancer, were associated with increased risk of breast cancer diagnosed before age 50. (Pader J et al., Cancer Causes Control 2021)
- Low fruit and vegetable intake and short or long sleep (<6 or >9 hrs/night, respectively) were associated with increased risk of lung cancer among non-smokers. (Murphy RA et al., in submission 2021)
- Diabetes was associated with MRI-identified vascular brain injury and cognitive impairment, implicating small vessel disease as an important link between diabetes and cerebrovascular disease. (Gerstein HC et al., J Clin Endocrinol Metab 2021)
- Atopic dermatitis was not associated with hypertension, type 2 diabetes, myocardial infarction or stroke, suggesting that it is not likely a major risk factor for cardiovascular disease. (Drucker AM et al., Br J Dermatol 2017)
- Increased total physical activity, vigorous-intensity activity, and walking were associated with decreased prevalence of obstructive sleep apnea. (Hall KA et al., J Clin Sleep Med 2020)
- Ethnocultural minorities were more likely to report suffering from mental health issues but less likely to access treatment. (Grace SL et al., BMC Psychiatry 2016)
- People who live in neighborhoods with a higher density of trees on their streets report significantly higher health perception and significantly fewer cardiometabolic conditions. (Kardan et al., Sci Rep 2015)
The following projects have been approved to use de-identified data from OHS participants and have met all requirements of the Study’s data access process.
Click each project below to read more.
Approved Projects – 2024
Applicant: Dr. Maneesh Sud, Dr. Dennis Ko
Institution: Sunnybrook Research Institute
Approval Date: November 2024
Project Summary: While heart disease is the leading cause of death worldwide, over half of new cases are potentially preventable. Globally, clinical practice guidelines recommend using prediction models to identify individuals who are most likely to benefit from treatments that may prevent heart disease. These models se age, medical conditions, physical measurements, labs, and medication history to predict the long-term risk of developing heart disease. Since 2012, Canadian guidelines have recommended using the existing Framingham Risk Score as a prediction model, even though it has not been tested in Canada to determine its accuracy for long-term predictions. Further, in the last decade, new models have been developed in Canada, Europe, and the United States that may have better accuracy than the Framingham Risk Score. Accordingly, it is unclear which prediction model is best for preventing heart disease in Canada. The objectives of this project are to create clinical and laboratory-based prediction models for long-term risks of heart disease, and we will test these models as well as existing models in current Canadian cohorts. We will also assess how these models impact existing primary prevention guidelines.
Objectives:
- To determine the relationship between sociodemographic and clinical factors with the long-term risk of developing heart disease in Ontario, Canada.
- To create new and confirm existing risk prediction models for long-term heart disease risk in Ontario, Canada.
- To test the impact of guideline decision-making using models created in objective 2 in Ontario, Canada.
Methods:
This project will utilize various population- and community-based cohorts at ICES to study primary prevention patients. Risk models will be created using existing CANHEART databases, its sub-cohorts (e.g., Canadian Community Health Survey and Electronic Medical Records Primary Care) and the Ontario Health Study. Models using laboratory-based information only will also be created by using the Ontario Laboratory Information System. Administrative, health services, physician billing, citizenship/immigration, clinical, electronic medical records, prescription medications, and laboratory databases will be linked. Models will be created using statistical regression methods that account for competing events of non-heart disease related death and use the timescale of study time (10-year predictions) and age (lifetime predictions). The created as well as existing models will be assessed and adjusted to determine the overall benefit. Groups of patients who should start treatment, according to guidelines, will also be included and assessed relative to the created and existing models. Data analysis will occur at ICES using SAS version 9.4 (SAS Institute, Cary, North Carolina).
Expected Impact:
This project will develop new and confirm existing risk models for use in a Canadian setting. This has the potential to inform future guidelines for preventing heart disease by using cholesterol and blood pressure lowering interventions.
Applicant: Dr. Giulia Muraca, Pruedence Hughes
Institution: McMaster University
Approval Date: October 2024
Project Summary: Obstetric trauma is an umbrella term that describes different types of injuries that can happen during childbirth. Canada has the highest rate of obstetric trauma in vaginal deliveries among countries that are a part of the Organization of Economic Cooperation and Development (OECD). The high rate of obstetric trauma could be impacting the rate of breastfeeding in Canada. Researchers have found that stress and pain caused by a difficult childbirth can impact the body’s ability to produce milk. This prevents individuals from being able to adequately breastfeed their baby, making birthing parents switch to formula. The pain can also impact an individual’s ability to get in the correct position for breastfeeding their baby. For example, it may hurt to sit up straight. Since breastfeeding has a lot of health benefits for both the birthing parent and the infant, it is important to investigate anything that may be causing issues with breastfeeding. We are planning to conduct a research study on people aged 15-55 in Ontario, looking at how obstetric trauma may have impacted their breastfeeding. Our first objective is to figure out if obstetric trauma impacted the duration a person was able to breastfeed. Our second objective was to examine how obstetric trauma impacted their ability to breastfeed while they were still in the hospital. For our first objective, we will use information from the Canada Community Health Survey (CCHS). The CCHS asked people how long they breastfed. We will use the responses to this question in the CCHS surveys administered during 2000-2016 to get information on breastfeeding duration. The Ontario Health Survey asked similar questions, so we will be using the responses from that survey as well. To see how obstetric trauma impacted breastfeeding duration, we will compare breastfeeding duration for people who did and did not have obstetric trauma. For our second objective, we will use information from the Better Outcomes Registry Network (BORN). BORN is a clinical maternity registry. Clinical registries are databases containing information about patient care and health. We will again compare breastfeeding in hospital between those who had and did not have obstetric trauma. The study will have many implications for clinical practice. It can change clinical practice, showing that people who suffer obstetric trauma require more support for breastfeeding.
Applicant: Dr. Faiyaz Notta
Institution: Princess Margaret Cancer Centre, University Health Network
Approval Date: September 2024
Project Summary: Pancreatic cancer is one of the deadliest cancers, with a survival rate of 10%. Most patients are diagnosed too late, when the tumour is too big or has invaded other organs, making it impossible to be removed by surgery. To improve the survival rate, we must find a way to detect the cancer at an early stage where it is still possible to be treated with surgery. However, pancreatic patients have no early symptoms and early detection relies on invasive imaging methods. In the last decade, blood-based detection methods have been developed for cancer screening, they are less invasive and have been proved useful for Breast tumours. This screening method usually consists of detecting DNA that is released from the tumour and circulates in the bloodstream. However, the drawback of using the circulating DNA is that it is not sensitive enough to detect small/early tumours. RNA circulating in the blood and extracted from the plasma portion of the blood, on the other hand, is derived from living cells, and the expression pattern of RNA can yield meaningful information. As the RNA is continuously being released into the blood stream, it does not depend on the tumour-size, is a very sensitive method and has the potential to detect early stages of the disease. In this proposal, we will look at the plasma circulating RNA patterns in pancreatic cancer patients and compare them to that of healthy donors. Our early results have demonstrated that the RNA pattern of the two groups is different, and we are looking to validate these results in a bigger sample size. Once we have developed a circulating RNA pattern that is distinct in the pancreatic cancer patient subgroup, we would like to also test this in individuals with high risk of developing pancreatic cancer (e.g., donors with a family history of pancreatic cancer, diabetes, obesity, smokers, etc.). The end goal is to use the circulating RNA method in combination with the circulating DNA method to increase the sensitivity of detecting pancreatic cancer at an early stage to give the patient a better chance of survival.
Applicant: Dr. Jennifer Brooks
Institution: University of Toronto
Approval Date: July 2024
Project Summary: This project focuses on investigating how environmental factors affect mental health and immune diseases in Canadians, using data from the CanPath study, which includes information on over 320,000 individuals across Canada. By linking this data with the Canadian Urban Environmental Health Research Consortium, the project aims to understand the impact of environmental exposures, such as air pollution and autoimmune diseases, or access to green space and mental health conditions. The project aligns with CanPath’s goals by utilizing its extensive datasets to explore how the environment influences health outcomes. This not only demonstrates CanPath’s capabilities in supporting research on the right to a healthy environment but also aids in securing funding for future sustainability efforts. Additionally, it showcases the potential for securing large grants for CanPath. As part of a 16-week practicum for four Master of Public Health (MPH) students, the project will culminate in each student producing a draft manuscript and presenting their findings in a CanPath webinar in August 2024. This provides a practical learning opportunity for the students while contributing valuable research to the field.
Applicant: Dr. Philip Awadalla, Yiran Shao
Institution: Ontario Institute for Cancer Research
Approval Date: July 2024
Project Summary: When people have chronic conditions like heart disease or cancer, their health journey often involves a progression of related health issues, rather than a straightforward recovery or decline following one diagnosis. However, we do not yet have a reliable way to predict what kinds of conditions a patient would develop over time, or understand which health factors or measurable signs are clues about how the disease will progress.
This project aims to create models that can predict the health paths for individuals based on a mix of factors like lifestyle, environment, and medical history. Using data from heart disease and cancer patients from specific health registries in Ontario, the study will map out the most common patterns of disease progression. With machine learning technique, the project seeks to forecast disease progression from one health issue to the next, taking into account a patient’s entire medical and lifestyle background. The results of this research can help improve how medical professionals assess risks, allowing them to watch more closely those who are at higher risk of specific comorbidities, and pinpoint which risk factors can be changed to possibly prevent worse health outcomes.
Applicant(s): Dr. Paul Nathan, Daksha Marfatia
Institution: Hospital for Sick Children
Approval Date: April 2024
Project Summary: Adolescents and young adults with cancer face unique challenges as their cancer diagnosis and treatment often occur while they transition into adulthood. This transition includes several developmentally important milestones including completing education, entering the workforce, and becoming financially independent. A cancer diagnosis during these years may complicate and even hinder their ability to achieve these goals leading to failure-to-launch and thrive phenomena. This can potentially have a negative impact on the quality of life for these patients as their career, earning potential, and long-term finances may be impacted. Thus, this study will investigate the impacts of a cancer diagnosis during this transition into adulthood on the later socioeconomic outcomes of these cancer survivors.
Applicant: Dr. Ann Burchell
Institution: Unity Health Toronto – St. Michael’s Hospital
Approval Date: February 2024
Project Summary: People living with HIV may be at higher risk for SARS-CoV-2 infection (the virus that causes COVID-19) or severe COVID-19 disease, than people without HIV. HIV affects the immune system’s ability to respond to infections and shares some of the same risk factors as COVID-19 such as older age, comorbidities, and lower income. Because of limited testing and surveillance gaps, we do not yet know how many people have been infected with SARS-CoV-2 and how strongly their immune system reacts to infection or COVID-19 vaccination, especially compared to those with people living without HIV. For this study, participants from the Ontario HIV Treatment Network Cohort Study (OCS), an existing study of people living with HIV who are receiving care in Ontario, were invited to collect a finger prick of blood at home. Blood samples were tested for antibodies to SARS-CoV-2 to see how many people were infected with the virus and whether these antibodies protected against re-infection. We will be comparing results to participants not living with HIV from the Ontario Health Study, who also completed the same procedure. These findings will inform health care and health services planning for people living with HIV in Ontario.
Approved Projects – 2023
Applicant: Dr. Jennifer Rabin
Institution: Sunnybrook Research Institute
Approval Date: December 2023
Project Summary: Two-thirds of people with Alzheimer’s disease are women. The reasons for women’s increased risk for Alzheimer’s disease are unknown. Menopause occurs when a decline in a hormone called estrogen causes middle-aged women to stop having menstrual periods. Interestingly, going through menopause at a younger age can increase risk for dementia. Cardiovascular conditions (e.g., high blood pressure, high cholesterol) are also associated with dementia and brain pathology in both sexes, but more so in women.
This study will test whether menopause and vascular risk factors together lead to dementia brain changes and worse cognition in women. We will also investigate whether other hormonal factors (including hormone therapy, birth control) protect against these cognitive and brain changes in women. Understanding why women are more likely to have Alzheimer’s disease is important for developing ways to prevent and treat dementia in both men and women. If menopause and vascular conditions work together to increase the risk of Alzheimer’s disease, interventions targeting both hormone changes and vascular health could reduce dementia rates in women.
Applicant: Dr. Amanda Sheppard
Institution: Ontario Health
Approval Date: November 2023
Project Summary: First Nations, Inuit, Métis and urban Indigenous (FNIMuI) populations have high rates of smoking and lung cancer compared to the rest of Canada. For people who are at a high risk of getting lung cancer, getting screened with a low-dose computed tomography (LDCT) scan is the best way to find lung cancer early, when treatment has a better chance of working. However, FNIMuI populations are often underrepresented in screening and experience barriers in accessing screening services. The current starting age of 55 for lung cancer screening may be too high for FNIMuI populations, who have a lower life expectancy than others in Canada. The objective of this project is to evaluate whether the current risk prediction model is accurately capturing the risk of developing lung cancer in FNIMuI peoples. Specifically, we want to examine whether FNIMuI peoples have an additional, independent risk of developing lung cancer, and whether they should start to be screened at a younger age. These findings will ultimately advocate for better screening guidelines and targeted recruitment strategies appropriate to FNIMuI populations, while remaining grounded in an understanding and respect for Indigenous determinants of health and ways of knowing.
This research application was also reviewed by the Joint Cancer Care Ontario Indigenous Cancer Committee.
Applicant: Michael Hoffman, Samantha Wilson, Philip Awadalla
Institution: University Health Network, OICR
Approval Date: October 2023
Project Summary: More than 10% of births are premature, and premature birth kills more Canadian children than any other cause. Babies delivered prematurely have increased risk for both short- and long term negative health consequences. There is currently no screening method to identify which pregnancies will deliver early. A method to detect pregnancies with a high risk of premature birth is needed to improve health outcomes for both the mother and baby.
During pregnancy, a fetus develops an organ called the placenta, which connects it to the mother and delivers nutrients from mother to fetus. DNA from the placenta circulates in the mother’s blood, along with the mother’s DNA. Many studies have used the sequence of circulating DNA to predict pregnancy complications. In this study, we will look at the chemical changes found between circulating DNA of healthy pregnancies and pregnancies involving premature birth. Specifically, we will look at DNA methylation, a kind of chemical change known to affect which genes are active in different human tissues.
We will identify changes in DNA methylation that can determine pregnancies with a high risk of premature birth. Since the test only uses DNA in the mother’s blood, we can do this with a non-invasive blood test with little additional risk to the pregnancy. As such, findings from this study can be easily applied to current pregnancy care.
This study will result in a non-invasive blood test that can detect pregnancies with increased risk of premature delivery. Use of this test will lead to changes in pregnancy care to try to prevent premature birth. This will lead to better long-term health for both mother and child. It will also decrease the need for the extreme medical care often used on premature infants. Improved health outcomes with decreased interventions will reduce costs to the Canadian health care system.
Applicant: Dr. Rachel Murphy
Institution: University of British Columbia
Approval Date: October 2023
Project Summary: More than 10% of births are premature, and premature birth kills more Canadian children than any other cause. Babies delivered prematurely have increased risk for both short- and long term negative health consequences. There is currently no screening method to identify which pregnancies will deliver early. A method to detect pregnancies with a high risk of premature birth is needed to improve health outcomes for both the mother and baby.
During pregnancy, a fetus develops an organ called the placenta, which connects it to the mother and delivers nutrients from mother to fetus. DNA from the placenta circulates in the mother’s blood, along with the mother’s DNA. Many studies have used the sequence of circulating DNA to predict pregnancy complications. In this study, we will look at the chemical changes found between circulating DNA of healthy pregnancies and pregnancies involving premature birth. Specifically, we will look at DNA methylation, a kind of chemical change known to affect which genes are active in different human tissues.
We will identify changes in DNA methylation that can determine pregnancies with a high risk of premature birth. Since the test only uses DNA in the mother’s blood, we can do this with a non-invasive blood test with little additional risk to the pregnancy. As such, findings from this study can be easily applied to current pregnancy care.
This study will result in a non-invasive blood test that can detect pregnancies with increased risk of premature delivery. Use of this test will lead to changes in pregnancy care to try to prevent premature birth. This will lead to better long-term health for both mother and child. It will also decrease the need for the extreme medical care often used on premature infants. Improved health outcomes with decreased interventions will reduce costs to the Canadian health care system.
Applicant: Walter Swardfager
Institution: Sunnybrook Research Institute
Approval Date: May 2023
Project Summary: Alzheimer’s disease (AD) is the commonest cause of dementia, in which patients will experience a progressive decline in cognition, language, memory, and physical ability. People with dementia due to AD in life are typically found to have multiple additional pathologies at autopsy. In particular, cerebral small vessel disease (SVD), is one of the commonest in the majority late-onset cases of AD (the more common form of AD and typically begins in patients age 65 and older). Cerebral SVD is a type of vascular lesion in the brain, with certain characteristic impairments in brain structures that can be assessed via magnetic resonance imaging (MRI). On the other hand, conventional genome-wide association studies (GWAS), a type of genetics analysis that surveys the whole genome for genetic variants associated with certain disease or physical traits, revealed ~21 genetic variants associated with AD. However, mechanisms underlying AD onset and progression remain unresolved. Conventional GWAS also focus on genetic variants with main effects and often eliminate variants that are likely to show conditional effects. A novel approach is to conduct a genome-wide interaction study (GWIS) which incorporates potential important interaction effects, along with a complementary candidate genes approach to focus on genes involved in specific biological functions and pathways. Here, I will survey the human genome for interactions between SVD brain imaging and genetic characteristics, which contribute together to increase the risk of AD diagnosis, and to AD-associated brain imaging and cognitive disease characteristics. The complex nature of AD pathology has posed a tremendous challenge in developing treatments for the disease. Via analyzing the above mentioned data variables in individuals with normal cognitive status and demented populations in the OHS, our goal is to disentangle the roles of various pathological factors underlying the clinical symptoms in order to overcome the tremendous challenge this poses in the quest for effective treatments.
Applicant: Jeffrey Brook, Xian Qian Lao
Institution: University of Toronto, City University of Hong Kong
Approval Date: March 2023
Project Summary: It is estimated that 6.6 million (11.8%) deaths were attributed to air pollution worldwide in 2019. Studies have documented that air pollution was linked to various circulatory and respiratory diseases and premature mortality. Previous studies mainly examined short-term exposure to air pollution, while few studies examined the effects of long-term exposure to air pollution. Long-term exposure may exert long-standing, irreversible and larger effects on human health in comparison, resulting in a much greater disease burden. Additionally, most of the studies were based on one regional cohort and thus the results were reflections of the specific region, making it difficult to generalize findings to different ethnic contexts with different exposure levels. This project aims to combine data from representative large cohorts from Asia, America, and Europe to determine the associations between long-term exposure to air pollution and the risk of chronic diseases and mortality. In addition, we aim to analyze the potential modifying effects by ethnicity, lifestyles, socio-economic factors, and pre-existing diseases and explore the potential mechanisms for the heterogeneity of the air pollution-health associations across different populations.
Applicant: Dr. Zena Samaan
Institution: McMaster University
Approval Date: March 2023
Project Summary: Opioid Use Disorder (OUD) has become increasingly concerning in North America. In North America, 3.9% of the population has been reported to use opioids, compared to 0.7% of people globally. The demographics in individuals living with OUD has shifted, from young male heroin users to users who are more likely to be older and have been introduced to the drug via prescription. Thus, it is important to determine what factors contribute to the development of OUD. Our interest lies in the possibility of the influence of an underlying genetic predisposition for the development of OUD.
Additionally, cannabis use is of additional concern in North America as trends in cannabis use rates have been increasing and individuals living with OUD have higher rates of cannabis use then the general population. A genetic component has been suggested in cannabis dependence with genes of interest identified, however, replication of these associations has been inconsistent. It is important to understand the genetic factors of cannabis use and how it impacts vulnerable populations such as the OUD population.
Our current study, the Pharmacogenetics of Opioid Substitution Treatment Response (POST), is a prospective cohort study which has collected genetic data on over 2,400 individuals receiving medication assisted treatment for an OUD population. We aim to combine our current genetic data with participants from the OHS dataset to perform a case-control genome-wide analysis to identify genetic variants associated with an OUD and with cannabis use.
Applicant: Dr. Alton Russell, Dr. Yuan Yu
Institution: McGill University
Approval Date: March 2023
Project Summary: Information on population immunity to COVID-19 comes from different types of studies. Some, like CanPath, invite randomly selected individuals to participate. Other studies use populations who are already having blood drawn, such as blood donors. While monitoring immunity levels with a convenient population like blood donors can be implemented quickly and inexpensively, some subgroups of the population may be underrepresented or missing, leading to ‘blind spots’. At the same time, response rates to surveys with randomly-invited participants during COVID-19 were low, which could also threaten the representativeness of those studies. In this study, we will compare COVID-19 antibody data from blood donors to CanPath and other studies with randomly sampled participants to assess differences in which sociodemographic and geographic subgroups are represented. We will also analyze the extent to which different methods of statistical adjustment can correct for underrepresentation of certain groups and improve the accuracy of population measures of COVID-19 immunity derived from both blood donor data and studies like CanPath.
Applicant: Dr. Bo Cao, Yutong Li
Institution: University of Alberta
Approval Date: January 2023
Project Summary:
Mental health disorders contribute significantly to global disability, accounting for 125.3 million years of healthy life lost in 2019. Despite their widespread prevalence (12,262 in 100,000 in 2019), current therapies often adopt a one-size-fits-all approach, overlooking critical factors like age, sex, environment, and socioeconomic status. Researchers are recognizing the need for personalized solutions and pioneering precision health – a paradigm shift in mental health treatment. Researchers are leveraging artificial intelligence and CanPath data to develop a new individualized mental health screening tool. This innovative approach not only enhances treatment effectiveness but also sheds light on how individuals’ backgrounds influence mental health outcomes, potentially identifying those at higher risk of developing mental health disorders in the future.
Approved Projects – 2022
Applicant: Dr. Frank Wendt
Institution: University of Toronto
Approval Date: December 2022
Project Summary:
Investigative leads in forensic casework often rely on genetic information associated with externally visible characteristics such as eye color and hair color. These traits are predicted using a small set of positions in the genome that, when occurring in the correct pattern, are predictive of blue eyes versus brown eyes, for example. Recent large genetic studies support the notion that these traits are far more complex than existing commercial products are capable of predicting. Furthermore, the pattern-matching used by commercial products may inadvertently detect off-target features of a person such as ancestry and even cancer risk. This project will uncover where biases exist in commercial algorithms that use genetic data to predict eye color, hair color, etc. and then build new prediction algorithms that are rigorously tested to avoid/minimize off target bias. This work will (i) inform best-practices for introducing low bias assays into the legal space, (ii) determine the ability of commercial assays to inform cancer, eczema, and psoriasis risk resulting from similar biological processes, and (iii) minimize the off-target effects of commercial algorithms towards maximizing public wellbeing and minimizing risk of undesired prediction outcomes. CanPath data for externally visible characteristics will be used to assess the ability of different machine learning algorithms to predict the target trait independent of ancestry confounding. Follow-up studies in CanPath data will discover regions of the genome associated with externally visible characterizes such that better algorithms can be developed and tested in external cohorts.
Applicant: Dr. Antoine Eskander
Institution: Sunnybrook Research Institute
Approval Date: December 2022
Project Summary: Hearing loss is very common and not only affects quality of life directly, but is also associated with dementia, depression, and more hospital visits. Cochlear implants are devices that rehabilitate hearing for patients with very severe hearing loss. Fewer than 10% of people who could benefit from a cochlear implant actually end up receiving one. It’s likely that part of the reason so few people get cochlear implants is because they have reduced access to healthcare. Studying the barriers to cochlear implant care is important so that we can improve the equity of hearing care in Ontario.
Cochlear implants are effective at improving hearing and improving quality of life. It is not known whether cochlear implants reduce the risk of other health problems associated with hearing loss, like depression and hospital visits. It is also not known how frequently cochlear implants cause problems in the long term that would require a revision surgery.
We aim to study cochlear implant recipients in Ontario to determine what barriers might exist to cochlear implant care. We will characterize the individuals who receive cochlear implants and compare them to individuals we think might benefit from a cochlear implant but haven’t received them. We will use that information to inform strategies to improve the equity of hearing care in the province. We will also study whether cochlear implants reduce the risk of developing depression, and whether they reduce how frequently a person visits a hospital and how much they cost the healthcare system. We will also study how often a cochlear implant recipient needs a revision surgery.
Applicant: Dr. Trevor Dummer, Ace Chan
Institution: University of British Columbia
Approval Date: May 2022
Project Summary: About 50% of cancer diagnoses are preventable by adopting healthy lifestyle behaviours such as limiting the consumption of alcohol and tobacco. World-renowned cancer research organizations have reported that there is no safe level of alcohol consumption or cigarette smoking that does not increase the risk of developing cancer. Gender minority (GM) people—people that have a gender identity that is different from their sex assigned at birth such as transgender men or transgender women—have a higher risk of developing cancer. Studies outside of Canada have demonstrated that this community has higher rates of cancer-causing substance use. One explanation for these higher rates is that there are additional stressors that GM people are exposed since they are a minority group. More research needs to be done, as data on Canadian GM people is limited as many surveys do not include a question that asks participants about their gender identity. This study will utilize data from The Canadian Partnership for Tomorrow’s Health (CanPath), a national longitudinal dataset, to explore the rates of alcohol consumption, tobacco use, cancer risk factors, and cancer diagnoses in GM people, compared to non-GM people. This data will also be used to determine how the rates of alcohol consumption and tobacco use changed in GM communities, since the COVID-19 pandemic, compared to non-GM communities. The results of this research will help researchers understand what resources need to be made available, and what types of policies can be developed to decrease cancer risk in GM communities.
Approved Projects – 2021
Applicant: Dr. Jennifer Brooks
Institution: Dalla Lana School of Public Health
Approval Date: July 2021
Project Summary: Genome wide association studies (GWAS) have been successful in identifying over 180 common susceptibility loci for breast cancer. However, heritability analyses indicate that breast cancer is a highly polygenic disease with thousands of common genetic variants of small effects, and that increasing sample sizes will generate new discoveries. The Confluence project aims to build a large research resource of over 300,000 cases and 300,000 controls of different ancestries—doubling current sample sizes to study the genetic architecture of breast cancer. This will be accomplished by the confluence of existing and new genome-wide genotyping data to be generated through this project.
CanPath will support the Confluence Study through contributing data and biosamples for genotyping for all incident prevalent and cancer cases. The inclusion of CanPath in Confluence will provide solid representation of Canadians in this international genotyping effort. This includes prominent minority populations in Canada, allowing Canadians to benefit from the findings of this ambitious project. Further, the generation of GWAS data through this effort will enhance the CanPath (and provincial cohort) data sets through the genotyping of all breast cancer cases and a selection of controls.
Applicant: Dr. Martin Carl Tammemagi
Institution: Brock University
Approval Date: June 2021
Project Summary: Lung cancer is the leading cause of cancer death in Canada and the World. Lung screening with computed tomography (CT) can identify lung cancers early, when they are still treatable, and can significantly reduce lung cancer deaths. Lung cancer screening works best when applied to high-risk individuals. The best way to identify high-risk individuals is by applying accurate lung cancer risk prediction models to estimate risk. One of the most widely validated and used models is the PLCOm2012 model.
We plan to use CanPath and CANUE data to improve PLCOm2012 risk prediction and make it more appropriate for application in the Canadian population by answering the following: Can adding (1) outdoor air pollution or lung cancer associated (2) occupational exposures improve risk prediction? Can we produce a model that will accurately predict lung cancer in (3) never smokers?
We plan to produce and evaluate mathematical models including relevant CanPath and CANUE data to answer these questions, and successful results should lead to improving selection of individuals for screening and reduce lung cancer deaths.
Applicant: Dr. Chris Verschoor
Institution: Health Sciences North Research Institute (HSNRI)
Approval Date: June 2021
Project Summary: The accumulation of health deficits, often used as a definition of the frailty syndrome, has been repeatedly shown as an effective and efficient risk stratification tool in older adults in both community and clinical settings. While it is commonly employed in cohorts of individuals 60 and over, some studies have also suggested that frailty may be an important health metric in much younger individuals.
We conducted a retrospective, longitudinal cohort study of over 161,000 adults aged 18 and older from Ontario, Canada, linking their self-reported health and sociodemographic data to administrative primary care databases. Over a median follow-up of 7.1 years, we found that a 30-item frailty index was associated with all-cause mortality, outpatient and inpatient admissions and length of hospital stay, regardless of participant age. Sex differences were apparent, but most interestingly, the association of frailty with most health outcomes decreased significantly with age. From this we can conclude that frailty is indeed associated with health outcomes, regardless of age, and further suggest that routine frailty screening at the level of primary care could pay significant dividends with regards to reducing future healthcare burden.
Publication: Verschoor, C. P., Theou, O., Ma, J., et al. (2024). Age- and sex-specific associations of frailty with mortality and healthcare utilization in community-dwelling adults from Ontario, Canada. BMC Geriatrics, 24, 223. https://doi.org/10.1186/s12877-024-04842-4
Applicant: Dr. Victoria Kirsh
Institution: Ontario Institute for Cancer Research
Approval Date: June 2021
Project Summary: The Ontario Health Study is conducting a COVID-19 Antibody Study. Participants are asked to complete an online questionnaire and provide a dried blood spot sample using a kit mailed to their home. The study is under way in all six regional CanPath cohorts.
The questionnaire includes details around vaccination (vaccine availability, willingness to receive the COVID-19 vaccine, and vaccination status, along with brand name and date received), previous COVID-19 infection (suspected only, or lab confirmed along with date of positive test), and underlying medical conditions diagnosed in the past year and medications taken. Dried blood spot samples are being tested for three antibodies to COVID-19. Two of these are represent an immune response to either prior infection or vaccine and the third represent a immune response to prior infection only.
We will determine whether immune response varies by brand of vaccine (Pfizer-BioNTech, Moderna, AstraZeneca), whether older individuals exhibit a weaker immune response and whether pre-conditions and or medical treatments affect immune response. We will also assess the direction and strength of the immune response over time.
With the majority of Canadians having received only a single vaccine dose, variation in immune response by type of vaccine has important implications for current public health guidance. Also, it will be important to monitor individuals with pre-conditions and or medical treatments to determine how treatment impacts the development of immunity over time.
Applicant: Dr. Helen-Maria Vasiliadis
Institution: Université de Sherbrooke
Approval Date: May 2021
Project Summary: COVID-19 has had an impact on people’s everyday life given strict physical distancing measures, confinement, the closure of non-essential services, the cancellation of non-emergency surgeries, interventions, and medical follow-up visits, as well as the way in which medical consultations are offered.
In Canada, what is currently unknown is the impact of COVID-19 of adult and older adults’ mental health and healthcare use during the pandemic. To our knowledge, this study is the first large-scale epidemiological dataset offering a unique opportunity to assess the impact of COVID-19 on depression, anxiety, and post-traumatic stress rates, health service use, and the mental health needs of adults and older adults across Canada.
This study relies on secondary longitudinal analyses of data from the CanPath project which includes information on health outcomes and physician diagnoses pre (2018) and during COVID (2020), in eight Canadian provinces (Québec, Ontario, Alberta, British Columbia, Nova Scotia, New Brunswick, Prince Edward Island, and Newfoundland and Labrador).
The specific objectives of this Pan-Canadian study are: 1) To ascertain the presence of a physician diagnosis of a mental disorder (major/minor depression, anxiety disorder, post-traumatic stress and obsessive-compulsive disorder, bipolar disorder, schizophrenia) and self-perceived mental health in Canadians prior and during the COVID-19 pandemic; 2) To identify the predisposing [age, sex, gender, education, race/ethnicity, medical professional/essential provider, etc.], enabling/impeding [province, income, marital status, employment status and changes, lifestyle behaviours, perception of COVID dangerosity, etc.] and need factors [changes in GAD-7 and PHQ-9 severity scores (pre-during COVID-19), mental and emotional health from before to after pandemic, presence of physical disorders, mental disorders, stress, pregnancy, financial worries, COVID infection, close contact with COVID, impairment, etc.] associated with perceived mental health /emotional need for help/aid/support because of the pandemic; receipt of health and social services (community organisations, professionals, help-lines, government support); and changes and delays to healthcare services since March 2020.
Logistic and multinomial multivariable analyses will be carried out to assess the factors associated with reported need for health and social services for mental health/emotional problems and receipt of services. Stratified analyses by age groups, sex/gender, race/ethnicity will also be carried out.
This evidence will inform Canada-wide and province-specific strategic planning for human and financial resource allocation and coordination of mental health primary care and psychological services in relation to generated increased prevalence and incidence rates of depression, anxiety, and post-traumatic stress disorders, as well as level of health service need. Findings will also identify at-risk groups to inform recommendations on tailored mental health strategies and additional resources required post-pandemic, as well as provide a comprehensive baseline portrait of mental health status and needs during the pandemic to prepare for Canada’s mental health response to future outbreaks. Findings will be shared with decision-makers and policy-makers to build health system capacity by appropriately matching access to service needs, as well as in peer-reviewer articles, conference workshops, websites, and local newspaper articles.
Publication(s):
Vasiliadis H-M, Spagnolo J, Fleury M-J, et al. (2023). Mental health service use and associated predisposing, enabling and need factors in community living adults and older adults across Canada. BMC Health Services Research, 23(1), 357. https://doi.org/10.1186/s12913-023-09335-5
Vasiliadis, H. M., Spagnolo, J., Bartram, M., et al. (2024). Factors associated with change in moderate or severe symptoms of anxiety and depression in community-living adults and older adults during the COVID-19 pandemic. Canadian Journal of Public Health, 115(2), 230–243. https://doi.org/10.17269/s41997-023-00832-y
Vasiliadis, H-M., Spagnolo J, Fleury M-J, et al. (2023). Factors associated with mental health service use during the pandemic: Initiation and barriers. The International Journal of Social Psychiatry, 70(1), 59-69. https://doi.org/10.1177/00207640231194489
Applicant: Dr. Philip Awadalla
Institution: Ontario Institute for Cancer Research
Approval Date: March 2021
Project Summary: Over the last 10 years, large efforts have been made around the world to reach out to participants from the general population to enroll into large biobanks, where information about their health and biosamples are collected. Such large biobanks have already been successful at identifying novel genetic determinants underlying disease susceptibility. However, given the nature of genetic determinant of diseases, very large sample sizes are required to explore the complete landscape of genetic susceptibility in disease. Also, rare disease require very large population cohorts to reach an acceptable sample size, which often cannot be achieve by a single biobank.
To address those issues, the Global Biobank Meta-analysis Initiative (GBMI) was launched, which comprise as of today more than 2.6 millions participants from 19 different biobanks from 11 countries, and aims to be a more definitive, global resource for human genetics. The GBMI aims at synergizing global efforts by demonstrating the potential of collaboration between groups with mature efforts and diverse analytic expertise.
Our main goal is to demonstrate that it is possible to merge and analyze multiple biobanks together and replicate findings for genetic determinants of common traits and diseases. In addition, the consortium goal is to demonstrate that by combining multiple biobanks, numbers can be achieved for rare diseases yet to be deeply studied because of a difficulty in finding sufficient numbers of affected participants. This project aligns with the OHS overarching goal of identifying genetic factors influencing disease risk, across age groups, ethnicities, and will help the scientific community to understand both common and more rare diseases.
Publications:
Zhou, W., Kanai, M., Wu, K. H., et al. (2022). Global Biobank Meta-analysis Initiative: Powering genetic discovery across human disease. Cell Genomics, 2(10), 100192. https://doi.org/10.1016/j.xgen.2022.100192
Wang, Y., Namba, S., Lopera, E., et al. (2023). Global Biobank analyses provide lessons for developing polygenic risk scores across diverse cohorts. Cell Genomics, 3(1), 100241. https://doi.org/10.1016/j.xgen.2022.100241
Applicant: Dr. Elena Netchiporouk
Institution: Research Institute of the McGill University Health Centre
Approval Date: March 2021
Project Summary: Eczema, psoriasis, and lupus are often very debilitating, autoimmune skin diseases, leading to severe symptoms, decreased quality of life, and decreased function and productivity. They are thought to arise in a genetically predisposed individual following an environmental exposure or stressor. However, little is known about the specific triggers that could be related to disease development. Adults spend a great deal of their everyday lives at work and certain jobs have concerns for possible chemical/toxin exposures which could potentially serve as a trigger to disease development. The aim of our project is to study the occupations of patients with eczema, psoriasis, and lupus and explore the associated chemical/toxin exposures related with that occupation. This will allow us to determine whether there could be a new occupational trigger responsible for disease development. In the future, this would help improve patient counselling regarding disease development, prognosis and management and also influence workplace regulations to help increase worker protection.
Applicant: Dr. David Birnie
Institution: University of Ottawa Heart Institute
Approval Date: February 2021
Project Summary: The etiology of sarcoidosis is still unknown and is likely related to a genetic susceptibility to unidentified environmental trigger(s). This study described a strong negative association between smoking history and a specific phenotype of sarcoidosis of primarily Caucasian patients with clinically manifest cardiac sarcoidosis. Non-smokers were found to have more severe myocardial inflammation than patients with a smoking history. Further research is needed to understand these associations and whether there is therapeutic potential.
Publication: Xu, C., Nery, P. B., Wiefals, C., et al. (2022). Negative Association of Smoking History With Clinically Manifest Cardiac Sarcoidosis: A Case-Control Study. CJC Open, 4(9), 756-762. https://doi.org/10.1016/j.cjco.2022.06.001
Applicant: Dr. Philip Awadalla
Institution: Ontario Institute for Cancer Research
Approval Date: February 2021
Project Summary: The human genome can be sequenced and analyzed to determine differences in genes among individuals. The gold-standard approach to study a genome is to perform short-read sequencing technology, which involves chopping DNA into small pieces, determining the genomic sequences of each piece, and placing them back together. While this is sufficient for most of the human genome, some genomic regions are very repetitive and difficult to accurately analyze, meaning scientists don’t always have information about genomic variants in these regions.
The goal of this study was to develop better computational methods for analyzing such repetitive regions, both for the standard short-read sequencing technology, as well as for newer long-read sequencing that allows for DNA to be analyzed in longer segments. We performed both types of sequencing methods on DNA samples from the Ontario Health Study, and we also used sequencing data from publicly available samples previously sequenced by other scientists.
Focusing on a gene called PRDM9 which contains a repetitive region of which there are over a hundred known variants in humans, we were able to correctly identify the genetic variants in approximately 42% of the samples tested using the models we developed for the short-read sequencing technology. For the long-read sequencing models we developed, we were able to identify the variants in about 98% of the samples.
Our research highlights the limitations of the current gold-standard short-read sequencing technology for highly repetitive regions of the genome, and shows progress with computational methods to overcome these limitations. We also highlight the advantages of long-read sequencing technology for accurately studying repetitive genomic regions.
Applicant: Dr. Aline Talhouk
Institution: University of British Columbia
Approval Date: January 2021
Project Summary: We will be using two risk models to predict the incidence of endometrial cancer and its precursor lesion, endometrial hyperplasia, in a Canadian population. These pre-existing models have both resulted in predicting a woman’s absolute risk of developing invasive endometrial cancer and can help to identify women who are at high-risk. This allows for targeted interventions to promote prevention along with early detection of cancer. By using the CanPath data, we will validate and improve these two pre-existing risk models by further exploring how additional factors, such as socioeconomics, ethnicity, gender variations and environmental exposures, may also contribute to endometrial cancer risk. Other health conditions are known to contribute to endometrial cancer, but their causal relationships have not been fully explored. Obesity, polycystic ovarian syndrome, and an increased exposure to female hormones are associated with higher incidence of endometrial cancer. Using data collected by CanPath, we will conduct our research using statistical and machine learning techniques. Machine learning is an application of artificial intelligence that enables us to analyze big data along with traditional epidemiological approaches. The purpose of creating an enhanced risk model is to reverse the current alarming trends in both incidence and mortality for endometrial cancer and to better understand health disparities in Canada. Our hope is that this model will identify high-risk women in Canada and recommend personalized prevention strategies based on a woman’s risk. These prevention strategies may include lifestyle modification, medication, and surgical prevention.
To identify which genetic variants an individual has, their sequenced DNA is compared to a gold-standard reference genome, and differences between the individual and the standard reference are identified. This is routinely done with short-read sequencing data, where the DNA has been chopped into millions of small pieces that are pieced back together using the reference as a guide.
However, for some regions that contain a lot of variants, the DNA is too different to be able to be compared to the reference and specific genetic variants cannot be identified. We are developing a computational approach that improves the ability to identify these genetic variants.
To evaluate the accuracy of our approach, we will compare our predictions with the variants identified from modern long-read sequencing technology that uses longer pieces of DNA to more accurately compare to the reference genome.
We hypothesize that our computational approach will be able to accurately identify genetic variants in complex regions using short-read sequencing data, allowing for elusive variants to be identified from the thousands of individuals with short-read sequencing data available for research.
Approved Projects – 2020
Applicant: Dr. Victoria Kirsh
Institution: Ontario Institute for Cancer Research
Approval Date: December 2020
Project Summary: In Canada, as of 23 October 2020, there have been at least 210,879 confirmed deaths and more than 210,879 confirmed cases in the COVID-19 pandemic. Our understanding of who is most vulnerable to severe COVID-19 disease is evolving, but data suggests that increasing age, obesity, and having underlying health conditions, including heart conditions, immunocompromised state, type 2 diabetes, cancer, chronic obstructive pulmonary disease put one at increased risk. There are many other conditions, lifestyle and environmental factors that might increase the risk for severe illness but for which there are limited data and information.
The regional cohorts of CanPath collected COVID-19 related data using an online questionnaire that can be integrated with data collected at baseline to: 1) generate descriptive data on the prevalence of infection in the population by person, place and time, and the constellation of symptoms; 2) quantify associations between risk of severe infection and i) comorbidities and/ or chronic conditions, ii) medication use, iii) exposures (air pollution, smoking, physical activity, body mass index), and iv) occupation (medical professional vs. other to indirectly assess the role of viral load) and; 3) evaluate the socioeconomic impact of the pandemic in terms of changes in i) employment status, ii) income, and iii) savings.
These findings will inform the public health response, including whom officials advise to be particularly stringent in observing social distancing, and the clinical triage protocol for surges in COVID-19 cases. This research will directly benefit individual Canadians, and enable an informed public health response.
Applicant: Dr. Jennifer Brooks
Institution: University of Toronto
Approval Date: November 2020
Project Summary: We have been able to make progress in our efforts to prevent death from breast cancer by making sure we catch breast cancer as early as we can. The earlier we find breast cancer, the better the chance that we will be able to treat it effectively. This project will help us understand how we can make sure women get breast screening they need and that we find the breast cancer as early as possible. In addition, we will also learn about more long-term and late health effects related to different types of breast cancer treatment. This information may be used by clinicians and other healthcare providers in treating women with breast cancer and the long-term care of breast cancer survivors.
Applicant: Dr. Darren Brenner
Institution: University of Calgary
Approval Date: October 2020
Project Summary: In this study, familial history of colorectal cancer and heavy smoking are important risk factors for early-onset colorectal cancer. Evidence was insufficient to conclude if alcohol intake, fruit and vegetable consumption, physical activity, or measures of adiposity are meaningful risk factors. The results of this study could inform targeted primary and secondary prevention for early-onset colorectal cancer.
Publication(s): O’Sullivan, D. E., Ruan, Y., Farah, E., et al. (2024). Risk factors for early-onset colorectal cancer: A Canadian prospective cohort study. Cancer Epidemiology. https://doi.org/10.1016/j.canep.2024.102578
Applicant: Drs. Philip Awadalla and Victoria Kirsh
Institution: Ontario Institute for Cancer Research
Approval Date: August 2020
Project Summary: We will leverage a decade of collaborative efforts by Canadian researchers, participants and international partners to rapidly generate high-quality data to support Canada’s response to the pandemic.
We will capture data and biologics to enable population-level surveillance, and enable researchers and clinicians to find factors contributing to COVID-19 susceptibility and severity (note: approval for additional biospecimen collection is not requested here and will be submitted in a separate request).
We developed the CanPath (Canadian Partnership for Tomorrow’s Health, which includes the OHS) COVID-19 online questionnaire in collaboration with over 90 national and international partners. With this online tool, we will collect information from population cohorts, patients from clinical cohorts and health care workers (through collaborations with UHN) and generate risk scores for infection and severity (using data on comorbidities, medication use, etc., adjusting for known confounders).
In addition to capturing a wealth of questionnaire data, we will focus on capturing administrative health and biosamples to prevent, detect, treat and manage COVID-19. We will leverage in-house research expertise to develop biomarkers to inform risk of disease, adverse outcomes and comorbidities. SUPPORT-Canada will include three core aims:
(1) Capture population and clinical-level COVID-19 data and outcomes to support personalized risk profiling, and inform adaptive public health responses;
(2) Create capacity for research in immunophenotyping, seroprevalence and host-viral genetics; and
(3) Explore genomic and co-morbidity/environmental interactions in shaping the pathophysiology of COVID-19 severity and susceptibility and immunological response.
Our platform has been designed to integrate with global research efforts to support clinical, immunological and genetic studies of COVID19. Our approach will enable rapid data sharing and translation of findings to the public health and research community.
Applicant: Dr. Victoria Kirsh
Institution: Ontario Institute for Cancer Research
Approval Date: June 2020
Project Summary: The Ontario Health Study is a population-based health cohort study that serves as a platform for investigating a variety of environmental, lifestyle, molecular, clinical and genetic factors associated with risks of cancer, vascular diseases, diabetes, and other chronic diseases.
To promote use of its extensive database among the health research community in universities, research institutes and government, we will publish baseline and follow-up descriptive data in the International Journal of Epidemiology (IJE).
We will address why the cohort was set up, who is in the cohort, how often they have been followed up, what has been measured, what has been found, what are the main strengths and weaknesses and details regarding how to get hold of the data.
We will report summary data – among OHS participants – on sociodemographic characteristics, physical measurements, prevalence of chronic conditions, incidence and mortality rates of various chronic diseases, and environmental exposures.
Read the OHS Cohort Profile Paper in the International Journal of Epidemiology.
Applicant: Dr. Sasha Bernatsky
Institution: Research Institute of the McGill University Health Centre
Approval Date: April 2020
Project Summary: There is a growing interest in the role of air pollution on inflammation and disease. Fine particles (PM2.5) in air pollution can enter the body through airways and can trigger an inflammatory response. Gases from traffic-related and industrial air pollutants may also have a direct effect on inflammation and disease.
Our team has shown an association between road-traffic density and rheumatic disease onset in Montreal, found links between PM2.5 levels and rheumatic disease activity, and suggested PM2.5 and industrial emissions as triggers of rheumatic disease.
The key areas that remain unknown are what types of pollution exposures might be most important, for both risk of antibody development and rheumatic disease risk. Our proposal will fill these remaining important knowledge gaps.
Applicant: Dr. Victoria Kirsh
Institution: Ontario Institute for Cancer Research
Approval Date: April 2020
Project Summary: Lung cancer is the most common cancer among Canadians, accounting for 14% of all new cases and 26% of all deaths.
The lung cancer five-year survival rate is among the lowest of the leading cancer sites; it is 18% overall and only 4% when the disease has already spread to distant sites.
Lung cancer is very rarely diagnosed at an early stage because the disease presents with few symptoms; non-smokers, in particular, are much more likely be diagnosed at a later stage since physicians are not usually looking for it in non-smokers.
This is a large study population and includes a large number of both smokers and non-smokers; it will provide a unique opportunity to focus on lung cancer risk among non-smokers in particular.
We will study the link between several suspected risk factors for lung cancer and cancer risk among participants in the various cohorts that comprise the Canadian Partnership for Tomorrow’s Health.
We will assess the risk of cancer according to 1) residential radon, 2) outdoor air pollution, and 3) diet.
The risk of lung cancer among never smokers may be increasing, which provides a strong imperative for continued research.
Our study has many novel features and provides a unique opportunity to gain information on lung cancer risk in a Canadian population and to directly inform public health strategy and prevention of this highly fatal disease.
Applicant: Dr. Andrew Lim
Institution: Sunnybrook Research Institute
Approval Date: March 2020
Project Summary: Sleep and circadian rhythm disruption affect millions of Canadians and may be contributing to the growing number of adults with impaired cognition and Alzheimer’s disease (AD) and other dementias.
This study is combining data from wearable technologies for comprehensive sleep and circadian assessment in community-dwelling working aged adults with detailed cognitive testing and brain scans to fill important gaps in our knowledge about the impact of sleep and circadian disruption on the brain changes related to AD and other dementias.
This study will facilitate efforts to use sleep and circadian screening to identify adults at high risk for AD dementia, support clinical trials of existing and emerging sleep and circadian interventions to decrease the growing burden of impaired cognition in old age, and may lead to targeted therapies that improve brain health for the millions of Canadians who experience sleep or circadian rhythm disruption.
Applicant: Dr. Jeff Kwong
Institution: ICES
Approval Date: February 2020
Project Summary: There is unequivocal evidence that long-term exposure to outdoor air pollution, even at the relatively low levels observed in Canada, is responsible for increased incidence of, and mortality from, major chronic diseases (e.g., cardio-respiratory diseases).
However, little is known about the impact of air pollution on shaping individuals’ physiological transformations (various disease states, frailty, and death). This information is crucial for supporting health guidance and preventive interventions, as well as for estimating the health burden of air pollution.
In this study, we aim to investigate causal relationships between air pollution and the incidence of major chronic diseases (e.g., diabetes, myocardial infarction, stroke, HF, COPD and asthma), subsequent hospital readmissions for these conditions, and non-accidental death.
We will carry out state-of-the-art mediation analysis to identify key pathways underlying the impacts of air pollution on human health that are of public health significance.
Publication: Zhang, Z., Wang, J., Kwong, J. C., et al. (2021). Long-term exposure to air pollution and mortality in a prospective cohort: The Ontario Health Study. Environment International, 154, 106570. https://doi.org/10.1016/j.envint.2021.106570
Approved Projects – 2019
Applicant: Dr. Will King / Dylan O’Sullivan
Institution: Queen’s University
Approval Date: December 2019
Project Summary: Exposure to solar ultraviolet radiation (UVR) occurs through spending time in the sun, in particular in summer months. Solar UVR can be both harmful and beneficial in terms of cancer risk. The causal relationship between exposure to solar UVR and skin cancer is established. Epidemiologic evidence suggests that solar UVR may be protective for other cancer sites. This research focused on the relationship between solar UVR and non-Hodgkin lymphoma (NHL), and explored the relationship with other cancer sites.
The Canadian Partnership for Tomorrow’s Health (CanPath) is a longitudinal cohort study designed to facilitate studies about the causes of chronic disease. For this study, information on sun behaviour and cancer outcomes comes from three CanPath provincial cohorts – the Ontario Health Study, Alberta’s Tomorrow Project, and Quebec’s CARTaGENE. The relationship between usual time in the sun during summer months and risk of NHL and other cancer sites was assessed, while controlling for other cancer risk factors.
In total, the study included a total of approximately 80,000 participants with an average follow-up of 8 years, and 205 cases of NHL occurred. Compared to those with less than 30 minutes of daily sun, those with moderated amounts of sun exposure (1 to 2 hours daily) were less likely to be diagnosed with NHL.
This study provided evidence of a protective effect of moderate time spent in the sun on NHL risk. Results are published in the journal Cancer Causes and Controls (O’Sullivan et al, 2023).
Publication(s):
O’Sullivan, D. E., Hillier, T. W. R., Brenner, D. R., et al. (2023). Time spent in the sun and the risk of developing non-Hodgkin lymphoma: A Canadian cohort study. Cancer Causes & Control, 34(9), 791–799. https://doi.org/10.1007/s10552-023-01719-6
Applicant: Dr. Rachel Murphy
Institution: University of British Columbia
Approval Date: November 2019
Project Summary: In Canada, 1 in 2 people will be diagnosed with cancer during their lifetime, with lung and prostate cancer being two of the most common cancers diagnosed. Many of these cancers may be prevented through lifestyle changes, including changes to diet and physical activity levels. However, the link between lifestyle and cancer is poorly understood. Only age, race and family history are well-known risk factors for prostate cancer and little is known about modifiable risk factors for lung cancer beyond smoking.
The project aims to carry out a series of studies to identify the lifestyle, and environmental factors that may increase the risk that a person will be diagnosed with lung or prostate cancer. Using data from the Canadian Partnership for Tomorrow Project, we aim to investigate known and potentially new risk factors for prostate and lung cancer collected from physical measurements, questionnaires, and blood samples, including medical history, lifestyle (diet, body size, sleep, physical activity), and environmental factors (e.g. exposure to toxins).
Cancer development was determined over 9 years, during which time more than 800 lung and prostate cancers were diagnosed. People who were diagnosed with cancer will be matched with a person of the same age, sex, and follow-up time for comparison. Statistical modeling will be used to identify new risk factors that may help identify people who are at risk of developing cancer. This information will inform public health efforts to prevent these cancers in the future and improve the health of Canadians.
Publication: Murphy, R.A., Darvishian, M., Qi, J., et al. (2022). Lifestyle factors and lung cancer risk among never smokers in the Canadian Partnership for Tomorrow’s Health (CanPath). Cancer Causes & Control, 33, 913-918. https://doi.org/10.1007/s10552-022-01566-x
Applicant: Dr. David Soave
Institution: Wilfrid Laurier University
Approval Date: October 2019
Project Summary: Previous research have suggested that psychosocial factors (e.g., depression, experiencing the loss of someone close, anxiety) can increase the risk for developing cancer. However, the findings are very mixed – and studies tend to vary a lot in how they have looked at this (e.g., focusing specifically on breast cancer).
In order to look at this in a rigourous way – PSY-CA (PSYchosocial factors and CAncer incidence) is a study in the Netherlands that will use data collected in 18 international studies. Using information from cancer registries, it is possible to look at the relationship between these psychosocial factors and cancer incidence.
As this involves many participants, it is possible to not only look at specific types of cancer, but also to look at whether the increased risk for cancer is particularly present in specific subgroups (e.g., smokers, those who are overweight).
Furthermore, we will also look at whether health behaviours explain the relationship between psychosocial factors and cancer incidence: for example, depression may lead to a decrease in physical activity.
Publications:
van Tuijl, L. A., Voogd, A. C., de Graeff, A., et al. (2021). Psychosocial factors and cancer incidence (PSY-CA): Protocol for individual participant data meta-analyses. Brain and Behavior, 11, e2340. https://doi.org/10.1002/brb3.2340
van Tuijl, L. A., Basten, M., Pan, K.-Y., et al. (2023). Depression, anxiety, and the risk of cancer: An individual participant data meta-analysis. Cancer, 129(20), 3287–3299. https://doi.org/10.1002/cncr.34853
Basten, M., Pan, K.-Y., van Tuijl, L. A., et al. (2024). Psychosocial factors, health behaviors and risk of cancer incidence: Testing interaction and effect modification in an individual participant data meta-analysis. International Journal of Cancer, 154(10). https://doi.org/10.1002/ijc.34852
Pan, K.-Y., van Tuijl, L., Basten, M., et al. (2024). The mediating role of health behaviors in the association between depression, anxiety and cancer incidence: An individual participant data meta-analysis. Psychological Medicine. https://doi.org/10.1017/S0033291724000850
Applicant: Maria Cusimano
Institution: University of Toronto
Approval Date: October 2019
Project Summary: Hysterectomy, or removal of the uterus, is the most common major surgery performed on non-pregnant women in North America. At the time of hysterectomy, women are also offered the option of bilateral oophorectomy, or removal of both ovaries, in order to prevent the possibility of developing ovarian cancer, a deadly disease, later in life. However, removing both ovaries also triggers early menopause, which may lead to serious health problems like heart disease, stroke, dementia, and osteoporosis. Existing data on the consequences of removing the ovaries are unclear and have some limitations.
In order to better quantify the long-term health effects of removing the ovaries, we will perform a large study of adult Ontario women undergoing hysterectomy and bilateral oophorectomy. We will use a repository of data held at ICES, a non-profit research institute in Ontario. Our study will be the largest of its kind and will address many of the limitations of earlier studies. It will provide information that women and doctors need to make the right treatment decisions.
Applicant: Dr. Lyle Palmer
Institution: University of Adelaide
Approval Date: September 2019
Project Summary: This project will be conducted by some of the many scientists and clinicians who designed and implemented the recruitment phase of the Ontario Health Study (OHS).
Analyses will use the OHS online questionnaire data collected at recruitment. We will conduct the analyses necessary to describe the OHS cohort’s design, methods, and the sample recruited at baseline. Detailed comparisons will be made to census data from Ontario.
Applicant: Dr. Prabhat Jha
Institution: Centre for Global Health Research, St. Michael’s Hospital
Approval Date: August 2019
Project Summary: Smoking remains a major cause of premature death worldwide. Despite a significant reduction in the frequency of adult smoking in high-income countries, about one-quarter of all deaths between 30 and 69 are still caused by smoking. Recent studies have shown the smokers who start early in life and don’t quit can expect to save a full decade of life. However, the absolute and relative risk reduction in clinically relevant subpopulations (e.g. among those who are diabetic, obese or hypertensive) remain unknown. Similarly, the benefits of cessation for different diseases, notably ischemic heart disease, stroke, various cancers and respiratory disease.
We pooled current or former vs never cigarette smoker hazard ratios from four prospective studies in the United States, United Kingdom, Norway, and Canada among adults aged 20-79, conducted from 1974-2018. We conducted Cox proportional-hazards model for estimated risk of death according to age at the time of smoking cessation for specific diseases organized by ICD-10, and random effects meta-analyses for combined with other cohorts. Excess risk reductions for cessation <3 years ago were smaller in men than in women. By contrast, absolute risk reductions were greater at older ages. Smoking cessation at any age, preferably early as possible, reduces smoking-attributable mortality rates substantially and, importantly, within just a few years.
Applicant: Dr. Geoffrey Anderson
Institution: University of Toronto
Approval Date: June 2019
Project Summary: Breast cancer is the most common form of cancer in women. Advances in treatment mean that more women are living longer after their breast cancer diagnosis. Research has shown that heart disease is a common cause of death in older women with breast cancer.
This research will determine which factors predict heart disease in women with breast cancer. This will allow women with breast cancer and their doctors to find out if they are at high risk for heart disease. This will help guide decisions related to breast cancer treatment selection and follow-up, improving patient outcome and quality of life.
Applicant: Dr. Esteban Parra
Institution: University of Toronto
Approval Date: January 2019
Project Summary: Hair and eye color (pigmentation) variation are primarily determined by our genes, and the environment has barely any impact. Pigmentation is primarily influenced by two types of melanin: eumelanin, which is a brown/black pigment, and pheomelanin, which is a red/yellow pigment.
People who have ancestors in Europe have a high diversity in hair and eye color. Our main goal is to find new genetic variants that determine hair and eye color variation in European populations. This can be done by comparing the self-reported hair and eye color of the participants of the Canadian Partnership for Tomorrow’s Health with their respective genomic variants.
Our study will provide novel insights about the genetic basis of hair and eye color, and is also of biomedical relevance, given the links that have been described between genetic variants associated with pigmentary traits and different forms of skin cancer, including cutaneous melanoma, squamous cell carcinoma (SCC) and basal cell carcinoma (BCC).
Publications:
Lona-Durazo, F., Mendes, M., Thakur, R., et al. (2021). A large Canadian cohort provides insights into the genetic architecture of human hair colour. Communications Biology, 4, 1253. https://doi.org/10.1038/s42003-021-02764-0
Lona-Durazo, F., Thakur, R., Pairo-Castineira, E., et al. (2022). Investigating the genetic architecture of eye colour in a Canadian cohort. iScience, 25(6), 104485. https://doi.org/10.1016/j.isci.2022.104485
Abbatangelo CL, Lona Durazo F, Wendt FR, et al. (2023). From Genetic Association to Forensic Prediction: Computational Methods and Tools for Identifying Phenotypically Informative Single Nucleotide Polymorphisms. Forensic Genomics, 3(2), 47-68. https://doi.org/10.1089/forensic.2023.0006
Approved Projects – 2018
Applicant: Dr. Darren Brenner
Institution: University of Calgary
Approval Date: October 2018
Project Summary: A University of Calgary epidemiologist is using data from Ontario Health Study (OHS) participants to explore how environmental or lifestyle factors could be associated with breast cancer in younger women.
Dr. Darren Brenner recently gained approval to study the de-identified data for female participants who were ages 35 to 50 and cancer-free at the time they joined the OHS. Questionnaire data from the OHS will be combined with Ontario Cancer Registry data to focus his work on those who have subsequently had a cancer diagnosis since joining the OHS.
Comparatively little is known about the risk factors for young-onset breast cancer, Brenner noted in his application to use OHS data. Inherited genetic mutations play a role, but generally only account for 5% to 10% of young-onset cases, suggesting lifestyle or environmental factors may contribute to the development of breast cancer in younger women. The role of obesity needs further study, he noted, as recent studies suggested a decreased risk for breast cancer in younger women with obesity.
Younger women diagnosed with breast cancer tend to have poorer survival rates because they are not routinely screened, and so tend to have an already-advanced stage of cancer once they are diagnosed.
Breast cancer remains the most commonly diagnosed cancer among Canadian women. Though the number of cancer diagnoses in older women has gone down over the last 25 years, the number of women under age 50 who receive a breast cancer diagnosis has increased. According to the Canadian Cancer Society, breast cancer accounts for 23% of diagnosed cancers in Canadians aged 30 to 49[1]. On a positive note, female breast cancer death rates have decreased an estimated 48% since they peaked in 1986[2].
In addition to using questionnaire data and blood samples from OHS participants, Dr. Brenner is also pulling similar data about British Columbian and Albertan women, through the Canadian Partnership for Tomorrow Project, Canada’s largest population cohort study.
Dr. Brenner and his team will examine the impact of lifestyle, environmental, and reproductive factors, family and medical history, as well as breast cancer screening protocols, on the risk for breast cancer in women under 50.
Results from their investigation could improve researchers’ understanding of young-onset breast cancer causes and could lead to improved prevention strategies.
Read more about Dr. Brenner and his other research projects in this article: ‘Research Rockstar’
[1] Canadian Cancer Statistics 2019 p. 14
[2] Canadian Cancer Statistics 2019 p. 7
Publication: Pader, J., Basmadjian, R. B., O’Sullivan, D. E., et al. (2021). Examining the etiology of early-onset breast cancer in the Canadian Partnership for Tomorrow’s Health (CanPath). Cancer Causes & Control, 32, 1117–1128. https://doi.org/10.1007/s10552-021-01460-y
Applicant: Dr. Vikki Ho
Institution: Centre de recherche du CHUM
Approval Date: September 2018
Project Summary: Worldwide, colorectal cancer is the third most common cancer. Men are more likely to develop colorectal cancer than women. Different environmental, lifestyle and biologic factors may explain this difference. Also, research is uncovering the role of estrogen, a hormone that promotes the development and maintenance of female characteristics, in preventing colorectal cancer in women.
Less is known of the role of hormones in the development of colorectal cancer in men. Similar to the evidence in women, there is support that the proper functioning of sex hormones may prevent colorectal cancer in men. Endocrine disruptors are chemicals that interferes with the proper functioning of sex hormones. We are exposed to these chemicals in the environment and in diet; however, workers in certain sectors are highly exposed to endocrine disruptors.
In this research, we will examine whether exposure to endocrine disruptors in the workplace increases the risk of colorectal cancer. Our research will be based within participants of the Canadian Parternship for Tomorrow Project. This study included men and women who have shared information on their health, lifestyle, environment and behaviours. Our research will include all men and women who were newly diagnosed with colorectal cancer since 2009. For comparison, we will select a sub-group of people, who have not had cancer at the beginning of the study. The interview asked detailed questions on the longest-held job for all participants. Using this information, we will determine whether exposure to endocrine disruptors at the longest held job was probable or not. We will compare the number of colorectal cancer cases among participants who were probably exposed to endocrine disruptors to those who were never exposed. This study offers a valuable opportunity to examine, in a short time frame and at low cost, whether endocrine disruptors play an important role in colorectal cancer risk.
Applicant: Dr. Vikki Ho
Institution: Centre de recherche du CHUM
Approval Date: September 2018
Project Summary: Being physically active have been shown to reduce the risk of some cancers. There are different types of physical activity, including activity at work and recreational activities. Participation in recreational activities has been shown to reduce lung cancer risk. However, the role of physical activity at work in affecting the development of lung cancer is not well-established. In fact, some studies have found that people who have physically demanding jobs also have a higher risk of lung cancer. As people spend many hours at work and some jobs are very physically demanding, new studies are needed to fully understand the role of physical activity at work on lung cancer development.
In this research, we will examine how lung cancer risk is associated with physical activity levels at work. Our research will be based on an ongoing Canadian study that began in 2009. Our research will include all men and women who were newly diagnosed with lung cancer since the study began. For comparison, we will also select a subgroup of people, who did not have a cancer at the beginning of the study. The interview asked detailed questions on the longest-held job for all participants.
Using this information, we will compare activity levels in the longest-held job between those who were diagnosed with lung cancer and those who remained cancer-free. This study offers a valuable opportunity to examine, in a short time frame and at low cost, whether physical activity at work plays an important role in lung cancer development.
Applicant: Dr. Philip Awadalla
Institution: Ontario Institute for Cancer Research
Approval Date: July 2018
Project Summary: The Canadian Partnership for Tomorrow Project (CPTP) is the product of $150+ million dollar investment to create first class infrastructure to support health research internationally. It is Canada’s largest population cohort with detailed data and biospecimens on 300,000+ adults. CPTP leaders have teamed up with scientists from a range of disciplines to enable a deeper understanding of how air pollution and the surroundings where people live interact with genes to influence cardiometabolic health. Existing data and resources are used to address essential questions for public health authorities, researchers, and health practitioners.
The focus is on metabolic syndrome (MetS), a cluster of medical conditions common among aging adults: obesity, hypertension, high cholesterol, high blood sugar, and insulin resistance. Because people with MetS are more likely to develop diabetes and cardiovascular disease, MetS represents a substantial burden on healthcare systems.
MetS results from the interaction of genes, lifestyle and the environment, but these mechanisms are not well understood. This program aims to quantify the effect of air pollution and built environment on MetS, and map differences in DNA that impact gene expression, and see if their effect are modified by environmental factors. Currently, no studies exist on the genetic and environmental risk factors of MetS at this scale, nor is there any program that has the infrastructure to return and share data with researchers to facilitate discovery.
Applicant: Dr. Sasha Bernatsky
Institution: Research Institute of the McGill University Health Centre
Approval Date: June 2018
Project Summary: Our CAnadian Network for Advanced Interdisciplinary Methods for comparative effectiveness research’ (CAN-AIM) aims to enhance the validity and accuracy of research on comparative effectiveness and safety of drugs. Comparative effectiveness research compares existing therapies to understand which treatment works best for which patients and, additionally, which treatments pose the greatest harm. To do so, CAN-AIM responds to queries on the drug safety and efficacy of medications on conditions such as hypertension, diabetes, rheumatoid arthritis, rheumatic diseases, inflammatory bowel disease and cancer.
Our CAN-AIM team is also well poised to respond to regulator requests regarding COVID-19 issues, including COVID-19 comorbidity/complications. Our approach uses both clinical and population-based cohorts and administrative data to produce timely answers to these questions. CAN-AIM is working with the provincial directors of Ontario, British Columbia, Alberta, Quebec and the Atlantic provinces contributing to the Canadian Partnership for Tomorrow’s Health (CanPath).
Publication: Danieli, C., Moura, C. S., Pilote, L., et al. (2023). Importance of accounting for timing of time-varying exposures in association studies: Hydrochlorothiazide and non-melanoma skin cancer. Pharmacoepidemiology and Drug Safety, 32(12), 1411–1420. https://doi.org/10.1002/pds.5674
Applicant: Dr. Trevor Dummer
Institution: University of British Columbia
Approval Date: May 2018
Project Summary: Population screening has been found to decrease the mortality and morbidity of cancer. Currently, cancer screening guidelines for breast, cervical, and colorectal cancer have been implemented or are in the process of being implemented across Canada, and close to 50% of Canadian men aged 40 years and older have been screened for prostate cancer in their lifetime. Nevertheless, the degree to which both physicians and patients comply to screening guidelines, and province-specific factors that affect screening utilisation, remain unclear. This project aims to use longitudinal, nationally representative data on over 300,000 Canadians from the Canadian Partnership for Tomorrow Project (CPTP) to examine differences in uptake and correlates of adherence to breast, cervical, colorectal and prostate cancer screening across Canadian provinces.
Publication: Darvishian, M., Moustaqim-Barrette, A., Awadalla, P., et al. (2023). Provincial variation in colorectal cancer screening adherence in Canada: Evidence from the Canadian Partnership for Tomorrow’s Health. Frontiers in Oncology, 13, 1113907. https://doi.org/10.3389/fonc.2023.1113907
Applicant: Dr. Dennis Ko (formerly Dr. Jack Tu)
Institution: ICES
Approval Date: April 2018
Project Summary: In this study, we plan to link survey information collected in the Ontario Health Study to other sources of health data, for example, hospitalization data and physician visit data.
The purpose of the study is to determine the cardiovascular (CV) risk factors, health services use, and clinical experience of survey participants at the level of individuals and communities.
This study will help us determine how representative participants of the survey are of the Ontario population; information that will be important for future research that uses the survey data.
Additionally, the community profiles we plan to develop as part of this study will improve our understanding of personal health behaviours and the influence of access to and the quality of health services on clinical events experienced by individuals within the community.
Finally, we will determine how well an established risk model for predicting cardiovascular disease performs in this cohort and whether we can develop better prediction models using the linked survey data.
Publication: Sud, M., Sivaswamy, A., Chu, A., et al. (2022). Population-based recalibration of the Framingham risk score and pooled cohort equations. Journal of the American College of Cardiology, 80(14), 1330–1342. https://doi.org/10.1016/j.jacc.2022.07.026
Approved Projects – 2017
Applicant: Dr. Sonia Anand
Institution: Hamilton Health Sciences
Approval Date: November 2017
Project Summary: Cancer, heart disease, stroke and brain health all impact the quality of life of people living in Canada, and also increase the cost of health care. The Canadian Alliance for Healthy Hearts and Minds (CAHHM) study has enrolled Canadian Partnership for Tomorrow Project (CPTP) cohort participants (along with other participants in CAHHM recruited from other cohorts) and will integrate the CPTP core questionnaire data of these participants, to better understand the early causes and risk factors of subclinical vascular diseases and how they progress to clinical disease.
We are also interested to determine how the places in which we live and work influence our lifestyles such as physical activity, food intake, and stress. Specifically the CPTP core questionnaire data will inform the sociodemographic, medical history, lifestyle factors, family history related to cancer and chronic diseases risk. By better understanding the causes of poor health and subclinical and clinical conditions, we will be able to identify key risk factors, and learn how to identify poor health early in order to optimize health services access and treatment for at risk individuals.
Publications:
Anand, S. S., Tu, J. V., Awadalla, P., et al. (2016). Rationale, design, and methods for Canadian alliance for healthy hearts and minds cohort study (CAHHM) – A pan-Canadian cohort study. BMC Public Health, 16, 650. https://doi.org/10.1186/s12889-016-3310-8
de Souza, R., Gauvin, L., Williams, N., et al. Environmental health assessment of communities across Canada: contextual factors study of the Canadian Alliance for Healthy Hearts and Minds. Cities & Health, 2(2), 163-180. https://doi.org/10.1080/23748834.2018.1548071
Hall, R. E., et al. (2020). The Canadian Alliance for Healthy Hearts and Minds: How well does it reflect the Canadian population? CJC Open, 2(6). https://doi.org/10.1016/j.cjco.2020.07.013
Anand, S. S., Friedrich, M. G., Desai, D., et al. (2020). Reduced cognitive assessment scores among individuals with magnetic resonance imaging–detected vascular brain injury. Stroke, 51(4). https://doi.org/10.1161/STROKEAHA.119.028179
Gerstein, H. C., Smith, E. E., Ramasundarahettige, C., et al. (2021). Diabetes, brain infarcts, cognition, and small vessels in the Canadian Alliance for Healthy Hearts and Minds Study. Journal of Clinical Endocrinology & Metabolism, 106(2), e891–e898. https://doi.org/10.1210/clinem/dgaa815
Durrani, R., Friedrich, M. G., Schulze, K. M., et al. (2021). Effect of cognitive reserve on the association of vascular brain injury with cognition: Analysis of the PURE and CAHHM studies. Neurology, 97(17). https://doi.org/10.1212/WNL.0000000000012765
Luu, J. M., Sergeant, A. K., Anand, S. S., et al. (2021). The impact of reporting magnetic resonance imaging incidental findings in the Canadian alliance for healthy hearts and minds cohort. BMC Medica Ethics, 22(1), 145. https://doi.org/10.1186/s12910-021-00706-3
Anand, S. S., Friedrich, M. G., Lee, D. S., et al. (2022). Evaluation of Adiposity and Cognitive Function in Adults. JAMA Network Open, 5(2), e2146324. https://doi:10.1001/jamanetworkopen.2021.46324
Luu, J. M., Gebhard, C., Ramasundarahettige, C., et al. (2022). Normal sex and age-specific parameters in a multi-ethnic population: a cardiovascular magnetic resonance study of the Canadian Alliance for Healthy Hearts and Minds cohort. Journal of Cardiovascular Magnetic Resonance, 24, 2. https://doi.org/10.1186/s12968-021-00819-z
Azab, S., M., Doiron, D., Schulze, K. M., et al. (2024). Exposure to air pollutants and subclinical carotid atherosclerosis measured by magnetic resonance imaging: A cross-sectional analysis. PLoS ONE, 19(10), e0309912. https://doi.org/10.1371/journal.pone.0309912
Applicant: Dr. Philip Awadalla
Institution: Ontario Institute for Cancer Research
Approval Date: August 2017
Project Summary: We will link participants in the Ontario Health Study with Cancer Care Ontario records in an attempt to better comprehend the development of specific cancers, such as breast cancer, prostate cancer, pancreatic cancer and all blood based cancers (myelomas, leukemia, and lymphomas). Specifically, we aim to develop early detection methods/biomarkers present in biosamples (blood, plasma, urine and genomic) before the first cancer diagnosis.
The OHS is a unique cohort relative to clinical cohorts, in that we have data and biologics collected from individuals who entered the study without a disease diagnosis and who have subsequently developed disease during the time that they participated in the study. The self-reported data, collected through baselines and follow-up questionnaires, can be used to test for associations between biological changes and changes occurring in response to disease status, environmental exposures, or drug regimens.
Administrative health linkages, obtained through Cancer Care Ontario, will provide us access to administrative health data that can be used to validate the self-reported data.
Publication: Chen, S., Petricca, J., Ye, W. et al. (2022). The cell-free DNA methylome captures distinctions between localized and metastatic prostate tumors. Nature Communications, 13, 6467. https://doi.org/10.1038/s41467-022-34012-2
Applicant: Dr. Darren Brenner
Institution: Alberta Health Services
Approval Date: February 2017
Project Summary: Despite well-established associations between modifiable lifestyle and environmental risk factors and cancer risk, reductions in these risk exposures have not produced declines in cancer incidence in Canada. This lack of change could be due to inadequate awareness among Canadians about the modifiable causes of cancer, and population-based cancer prevention strategies based on outdated information.
To improve on this, we are conducting a study that will estimate the number of cancer cases, now and in the future, that could potentially be prevented through changes in modifiable lifestyle and environmental risk factors associated with cancer. These risk factors include tobacco smoking, dietary intake, physical activity level, body weight, environmental factors, infectious diseases and hormonal therapies.
This study will produce the most comprehensive dataset of its kind ever in Canada based on the most up-to-date epidemiologic evidence of cancer risk and contemporary exposure prevalence data. This information will be invaluable for a broad range of knowledge users including policy makers, to target the exposures and cancer prevention interventions with the greatest potential for population-level impact.
Approved Projects – 2016
Applicant: Dr. Isabel Fortier
Institution: Research Institute – McGill University Health Center
Approval Date: December 2016
Project Summary: This project aims to explore different approaches of data harmonization (enhancing quality and utility) by examining the determinants of age at menopause among participants of large population-based studies. Age at menopause is related to women’s health. In addition, it is considered as a marker of human health as its late occurrence may reduce risks of cardiovascular diseases and its early occurrence may reduce risk of breast, cervical and endometrial cancers.
Through this study, we will use and compare different methods of data harmonization to assess the lifestyle, sociodemographic, environmental, and reproductive health-related factors related to age at menopause in Canada and these results will be compared to European studies. Age at menopause and all confounding factors data will be obtained from baseline assessments of LifeLines, the Canadian Partnership for Tomorrow Project and UK-Biobank studies.
Applicant: Dr. Aaron M. Drucker
Institution: Brown University
Approval Date: August 2016
Project Summary: Eczema, also known as atopic dermatitis, is a common skin condition that has been associated with risk factors for heart disease and stroke. Very few studies have actually looked at whether eczema predisposes people to develop heart attacks or strokes. We plan to use data from the Canadian Partnership for Tomorrow Project to investigate whether having eczema makes people more likely to develop high blood pressure, diabetes, heart attacks or strokes. We expect to find that people with eczema do develop high blood pressure, diabetes, heart attacks and strokes more than people without eczema. If our findings are consistent with our expectations, that would lead to further research into why people with eczema are at higher risks and to efforts to decrease the risk of those conditions in patients with eczema.
Publication: Drucker, A. M., Qureshi, A. A., Dummer, T. J. B., et al. (2017). Atopic dermatitis and risk of hypertension, type 2 diabetes, myocardial infarction and stroke in a cross-sectional analysis from the Canadian Partnership for Tomorrow Project. British Journal of Dermatology, 177(4), 1043–1051. https://doi.org/10.1111/bjd.15727
Approved Projects – 2013
Applicant: Dr. Sutapa Mukherjee and Woganee Filate
Institution: Women’s College Research Institute
Approval Date: April 2013
Project Summary:
Sleep that is too short or too long in duration is an important marker of sleep quality, general health, and chronic disease risk. Little is known regarding the inter-relationship of ethnic background with sleep duration. We studied a large, population-based, multi-ethnic sample of adults (aged at least 18 years) from Canada – the Ontario Health Study – to address this question. We found significant differences in self-reported average sleep duration by ethnic group. Subjects in all ethnic groups were, on average, either at the lower end or below recommended guidelines for healthy sleep. Average sleep duration was highest in White adults, and lowest in Black and Filipino adults. Poor sleep has an impact on general health and lifestyle and is also associated with increased morbidity. On average, Canadian adults are sleep restricted or at the lower end of recommended guidelines for healthy sleep. We found that significant ethnic differences exist for self-reported sleep duration among residents of Ontario, and that both ethnicity and sleep duration were independent risk factors for common chronic diseases. Differences in sleep duration, especially short sleep, were highly correlated with an increased risk of poor health outcomes and may contribute to observed health disparities amongst ethnic groups. Further research is warranted to investigate the possible factors that contribute to the shorter sleep duration observed in certain ethnic groups and in men, and to implement strategies to improve sleep duration and sleep quality in the Canadian and other populations.
Publications:
Hall, K. A., Singh, M., Mukherjee, S., & Palmer, L. J. (2020). Physical activity is associated with reduced prevalence of self-reported obstructive sleep apnea in a large, general population cohort study. Journal of Clinical Sleep Medicine, 16(7), 1179–1187. https://doi.org/10.5664/jcsm.8456
Singh, M., Hall, K. A., Reynolds, A., et al. (2020). The relationship of sleep duration with ethnicity and chronic disease in a Canadian general population cohort. Nature and Science of Sleep, 12, 239–251. https://doi.org/10.2147/NSS.S226834
Applicant: Dr. Marc Berman
Institution: Rotman Research Institute at Baycrest
Approval Date: January 2013
Project Summary: Many of us fail to realize just how much the surrounding environment impacts our behavior. Researchers have found that graffiti on mailboxes increase the propensity of people to steal (Keizer, Lindenberg, and Steg, 2008), and that dilapidated neighborhoods encourage crime (Johnson, 2009).
But the environment can also have positive effects; there is a growing literature showing that brief interactions with nature, such as a walk in a park, can have beneficial effects on mental and physical health (Berman et al., 2008; Berman et al., 2012; Kaplan & Berman, 2010; Ulrich, 1984; Kuo & Sullivan, 2001; Cimprich & Ronis, 2003).
In this project, we will examine these relationships on a much larger scale: we will ask whether the naturalness of different neighborhoods around the Greater Toronto Area is related to physical and mental health, while controlling for confounding variables such as SES.
We will also be able to uncover the relationships between mental and physical as moderated by the naturalness of the environment. This project will help us to quantify the health benefits of naturalness in urban areas, which will have wide ranging applications for both health scientists and policy makers.
Publication: Kardan, O., Gozdyra, P., Misic, B., et al. (2015). Neighborhood greenspace and health in a large urban center. Scientific Reports, 5, 11610. 10.1038/srep11610
Approved Projects – 2012
Applicant: Dr. Sherry Grace
Institution: York University
Approval Date: March 2012
Project Summary: Mental disorders are an important cause of disability and early death in Ontario. It is estimated that one in five Canadians will experience a mental illness in their lifetime.
In this project, the psychosocial well-being of participants in relation to their determinants of health will be described within the contect of the largest population-based study carried out to date in the province, the Ontario Health Study (OHS).
A pilot study that included assessments of mental health and determinants of health was carried out prior to the main cohort of OHS. The pilot questionnaire contains questions that measure psychosocial well-being by examining symptoms of depression and anxiety, social support, stress at home and work, and stressful life events.
Psychosocial well-being will be described by social characteristics (such as age, gender, education, marital status, first language, ethnicity and household income) that may play a role in determining the health of an individual. Findings will be compared to what is previously known.
The research may help identify determinants of health that contribute to mental disorders within Ontario and as a result, lead to measures aimed at reducing the effects of mental disorders.
Publication: Grace, S.L., Tan, Y., Cribbie, R.A., Nguyen H, Ritvo P, Irvine J. The mental health status of ethnocultural minorities in Ontario and their mental health care. BMC Psychiatry, 16, 47. 10.1186/s12888-016-0759-z
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