The SUPPORT-Canada initiative will capture data and biospecimens in order to identify factors contributing to COVID-19 susceptibility, severity and outcomes in Canada. June 25, 2020 – Toronto, Ontario CanPath (the Canadian Partnership for Tomorrow’s Health) has been awarded a $2.1 million grant from the Canadian Institutes of Health Research (CIHR) through their COVID-19 Rapid Research Funding competition. The initiative, titled SUrveying Prospective Population cOhorts for COVID-19 pRevalence and ouTcomes in Canada (SUPPORT-Canada), aims to capture data and biospecimens to enable population-level surveillance. SUPPORT-Canada will enable researchers and clinicians to find factors contributing to COVID-19 susceptibility, severity and outcomes, thus identifying factors predisposing individuals or communities across Canada to a high risk of infection. “The integration of clinical programs with our broader existing population cohort infrastructure creates the opportunity to rapidly assess patterns across Canada, while discovering and tracking critical biological and environmental determinants of disease susceptibility and severity for COVID-19,” says Dr. Philip Awadalla, lead Principal Investigator for the SUPPORT-Canada Initiative and National Scientific Director of CanPath. SUPPORT-Canada will be built out from CanPath, Canada’s largest population cohort, in partnership with the Toronto-based University Health Network (UHN), along with support from numerous research platforms, industry collaborators and service providers. This collaborative effort has been designed to integrate with national and global research efforts, including the COVID-19 Host Genetics Initiative, to support clinical, immunological and genetic studies of COVID-19. SUPPORT-Canada aims to: Capture population and clinical-level COVID-19 data and outcomes to support personalized risk profiling, and inform adaptive social and public health responses; Create capacity for world-leading research in immunophenotyping, seroprevalence and host-viral genetics; and Explore the role that genetics, co-morbidities and the environment play in shaping the pathophysiology of COVID-19 severity, susceptibility and immunological response. “Accurate estimates of SARS-CoV-2 antibodies across Canada, which act as markers of infection, are needed to guide ongoing public health measures, particularly those being developed in anticipation of a second wave of disease. This characterization of the evolution of the COVID-19 infection will prove vital in decision-making about immunization and protection strategies,” says Dr. Philippe Broët, who is leading the serological surveillance aspect of the grant and is Co-Scientific Director of CARTaGENE, a member cohort of CanPath. Preliminary evidence indicates that increased air pollution is both a risk factor for COVID-19 and associated with increased disease virulence, while other features of the built environment, such as green space and neighbourhood walkability, are thought to be risk factors. “Given current resource shortages, the healthcare system would benefit from patient-specific algorithms to distinguish who is likely to develop severe disease and identify biomarkers to predict future complications, as the long-term outcomes remain unknown and pose a significant threat for the future burden of disease in the population,” says Dr. Trevor Dummer, who is leading the third aim of the project and serves as Co-Scientific Director of the BC Generations Project and National Scientific Co-Director of CanPath. “Surveying our large number of engaged participants across the country powers us to determine specific genetic and environmental interactions that together may be used to identify hotspots of risk across Canada”, adds Dr. Awadalla, who is also Executive Scientific Director of the Ontario Health Study. CanPath launched a survey in April that captures not only COVID-19 testing information, but also symptoms, clinical history, and asks participants how the pandemic has affected their mental health. CanPath’s initiative is one of 139 research projects that have received more than $109M in funding  from CIHR for COVID-19 research. This investment supports research teams from across the country to focus on accelerating the development, testing, and implementation of measures to mitigate the rapid spread of COVID-19 and its negative consequences on people, communities, and health systems. The SUPPORT-Canada research team includes co-investigators from all of CanPath’s regional cohorts, as well as experts in immunology, genomics and biobanking from the Ontario Institute for Cancer Research, University Hospital Network and Mount Sinai Hospital. The CIHR grant will be awarded through the Ontario Institute for Cancer Research, which is a partner with the University of Toronto’s Dalla Lana School of Public Health in supporting CanPath.  

It is well established that race is a key determinant of health. We know that race affects health outcomes and that BIPOC communities have been disproportionately affected by COVID-19 and by environmental racism, including in Atlantic Canada. This is clear evidence of the inequity in our society.   Intersectionality should be a core tenet of health research. We recognize that racism exists within the research community and that there is much work to be done. #BlackInTheIvory We support Dalhousie University’s Vice-Provost, Equity and Inclusion, Dr. Theresa Rajack-Talley and the formal acknowledgement that “we have an obligation to provide an education and a community that works together to address systematic anti-Black racism and all forms of discrimination and intolerance.” Atlantic PATH is committed to being an anti-racist organization. We are dedicated to providing equal access to data and to supporting researchers throughout the research process.  We aim to continually reflect on our policies and practices so that we may do our part in working towards an equitable research community.

Questionnaire data from the first Atlantic PATH follow-up survey is now available to researchers!   Between 2016-2019 participants were invited to complete the first follow-up questionnaire. More than 21,000 Atlantic PATH participants completed the follow-up questionnaire. That data underwent a harmonization process across all the cohorts and is now available to researchers.   The questionnaire seeks information about a person’s health that may have changed since the first time they provided information.   The follow-up dataset includes the following: Demographic Mental Health Health status Medical history Prescribed medication Family health history Behaviours (sleep, alcohol, tobacco, marijuana use, and e-cigarette use) Working status Household income Anthropometric measurements   More information about the questionnaires can be found here.  Learn more about the Data Access Process.

The Future of Prevention is Almost Here Researchers are conducting experiments to observe if diseases can be prevented before developing through exercise, diet, or changing your environment. Imagine knowing years in advance that you are likely to develop a serious disease and then discovering the lifestyle changes you can make to lower the chances of that happening. The Canadian Partnership for Tomorrow’s Health (CanPath) is aiming to create a future where links between the onset of disease and factors related to lifestyle, genetics, and the environment are much clearer. As the largest health research platform in Canadian history, CanPath includes more than 300,000 participants between the ages of 30 and 74 who were recruited through five regional cohorts representing eight provinces (BC Generations Project, Alberta’s Tomorrow Project, Ontario Health Study, CARTaGENE, and Atlantic PATH). Over the next 25 years, some participants will develop cancer or other diseases and the accumulation of CanPath data and biosamples will allow researchers to conduct important population-health studies. They will determine links between the onset of illness and risk factors — including those that can be modified like diet and exercise, those that can’t be modified due to genetics, and those that are largely based on environmental exposure. “The data can touch every aspect of future health research because it gives you a time capsule to go back and see what people were doing before they developed certain diseases,” says Dr. Craig Earle, Vice President of Cancer Control at the Canadian Partnership Against Cancer. The organization is a critical investor in, and the founder of, CanPath. CanPath building ‘world-class’ health resource CanPath data and biosamples were used in a study that determined that air pollution can alter DNA. Dr. Philip Awadalla, National Scientific Director of CanPath, notes that gene expression signatures largely follow where you live, rather than your ancestry. Dr Awadalla is with the Ontario Institute for Cancer Research and the University of Toronto — the university recently became the national scientific home of CPTP. “By tracking the health of participants over an extended period of time, we will be acquiring knowledge that could help with disease prevention down the road,” he says. Dr. Awadalla envisions that CanPath will enable a future where doctors will be armed with new genetic tools or biomarkers in order to advise patients on the steps they can take to prevent the onset of various diseases in the same way they now advise patients to stop smoking to avoid lung cancer. “CanPath is a great example of pan-Canadian cooperation to build a resource for health research that is world-class and unique for medicine,” says Dr. Earle. “It is going to be yielding benefits for decades to come.”

U of T to Lead Canada’s Largest “Living Population Laboratory” (Original Post at University of Toronto) The University of Toronto has been selected to serve as the national scientific partner of the Canadian Partnership for Tomorrow’s Health (CanPath), Canada’s largest population research platform that is unlocking the answers to why some people develop cancer and chronic diseases while others do not. Through a national competition by the Canadian Partnership Against Cancer, Professors Philip Awadalla, in the Faculty of Medicine, and John McLaughlin, in the Dalla Lana School of Public Health, were chosen to lead CanPath into its next phase as Canada’s premier health research initiative. This announcement coincides with a recent publication led by Professor Awadalla that received widespread media attention, including in the Globe and Mail, in which analyses of CanPath data from Quebec revealed how air pollution and other environmental factors influence gene expression and disease. “CanPath enables precision health research because it’s a living population laboratory,” said Philip Awadalla, who is a Professor of Population and Medical Genetics in the Faculty of Medicine’s Department of Molecular Genetics, and will now serve as National Scientific Director for CanPath. The Canadian Partnership for Tomorrow’s Health has more than 300,000 participants, aged 30-74, who have voluntarily provided health and biological information, which can be used by researchers to conduct long-term population health studies. As participants age, some will develop a range of conditions, which allows researchers to search for factors linked to disease onset and progression. These types of studies can detect health links with genetic, environment, behaviour and societal factors. “We are honoured and grateful for the opportunity to lead this major program at U of T in partnership with many contributors across Canada,” said John McLaughlin, who is a Professor of Epidemiology at the Dalla Lana School of Public Health, and will now serve as CanPath’s Executive Director. “While benefiting from the University’s massive research capacity and range of expertise, we will work collaboratively with our many partners to heighten scientific outputs and impacts, enrich the platform with new data linkages, and work with researchers across campus and across Canada who share our vision of how health and health systems can be improved nationally,” said McLaughlin, who is also Chief Science Officer at Public Health Ontario. “By deeply characterizing and following the health of Canadians, we will be able to develop and optimize tools that slow or prevent disease evolution in an individual. The future of this program is reliant on research and discovery by the research community and the continued participation of Canadians to unlock the genetic and environmental factors associated with the development of disease,” said Awadalla who is also Director of a Genome Canada genomics platform, at the Ontario Institute for Cancer Research, a strategic partner for the project. U of T is the natural home for the second phase of the CanPath because of its strong track record of world class population health, biomedical, and health services research and education, combined with its impressive faculty with extensive experience leading large-scale studies and research networks. “We aim to attract more national and international researchers who can use the platform to further their own research as well as actively engage with CanPath leadership and expand its future direction,” said France Gagnon, Associate Dean of Research at the Dalla Lana School of Public Health.

Ambitious new study is a powerful tool in the fight against cancer and chronic disease (Originally Published on National Post) A new and powerful resource is now available in Canada to help researchers in the fight against cancer and other chronic diseases. The Canadian Partnership for Tomorrow Project (CPTP) is the first national database designed to both document and follow the health of hundreds of thousands of Canadians for decades to come. CPTP seeks to better understand the complex pathways of disease, and is aimed at improving health outcomes for the next generations. CPTP is the largest research database ever built in Canada, comprising harmonized information from five regional population health studies. Participants were recruited from British Columbia, Alberta, Ontario, Quebec and the Atlantic provinces. Dr. Catherine Boileau is the Director of Epidemiology at CARTaGENE, CPTP’s Quebec partner. She says the database offers researchers an opportunity to focus on analyzing data rather than starting from scratch to set up studies and recruit participants. Researchers have access to a wealth of biological and health data through a simple online request process. “Collecting information, collecting biological material and physical measurements costs a lot of money,” Dr. Boileau notes. “Gaining access to this resource saves money and time. Instead of having to collect data, recruit people and process biological material, researchers can now access the high-quality biological material they need [through CPTP].” Study participants are between the ages of 30 and 74, and have volunteered to provide updated health information over the course of their lives. They come from varying socio-economic backgrounds, and live in both large urban centres and remote rural towns. All have volunteered to fill out a baseline survey that includes detailed questions on their medical history, diet and lifestyle. They have also agreed to link their questionnaires and any bio-specimens with information from electronic health records. Nearly half of CPTP participants have provided blood samples that can be used for biochemical research. There are also 100,000 urine samples, as well as 45,000 blood spots and saliva samples that are additional sources of DNA. CPTP bio-samples also include more than 30,000 toenail clippings that can be tested for environmental exposure to toxins. “Researchers now have at their fingertips a valuable resource they can use,” says Dr. Trevor Dummer, co-leader of the West Coast’s regional population study, the BC Generations Project.  He notes the national sample size represents about one in 50 Canadians within the CPTP’s age group. “We have gathered a lot of information on a large proportion of Canadians. Now that the infrastructure has been created, it is going to accelerate the speed at which we can do research studies.” Accelerated research into the risk factors for cancer is of particular urgency. Despite important advances made in recent decades, cancer remains a formidable adversary for those looking for new prevention strategies and treatments. The disease is complex, unpredictable, and the leading cause of death in this country. As Canada’s population ages, cancers are expected to become even more prevalent, and are forecast to rise by about 40 per cent by the year 2030. CPTP offers a unique window into the genetic make-up and health of people from across the country. It has significant statistical power to explore how genetic predispositions and environment can influence cancer risks. The database gives researchers a new opportunity to scale up their work to include more data from Canadians from diverse geographic regions. “You can test out whether a particular hypothesis in one province may hold true in other populations,” Dr. Dummer says. He points to a research project he and his colleagues are pursuing in B.C., on how urban development can impact people’s health in Metropolitan Vancouver. With CPTP, there is potential to expand the study to include people from other regions of the country. “You can see whether health outcomes in British Columbia hold true for the Prairies. It effectively enables us to do a number of cutting-edge projects.” CPTP is still considered a young population health research study. Its greatest value, according to Dr. Boileau and other researchers, may well be found in the years and decades to come. As the regional population health studies return to their participants for updates, the new information gathered might help shed light on why some people develop cancer and other chronic diseases while others don’t. “We are just beginning. We plan to follow participants for many years, and the study will become more valuable with time,” says Dr. Boileau. “We will be able to compare people who were exposed to different risk factors, and at what rate they develop these diseases.” Dr. Boileau adds that as researchers return the findings of their studies to the cohorts, they will enhance the quality of the data. The more researchers use the database, the more questions CPTP might be able to help answer. The door is now open for independent investigators to use this new national resource – one that holds great potential for scientific discovery.

National database offers new tool in fight against chronic disease (Originally Published on National Post) A new and powerful resource is now available in Canada to help researchers in the fight against cancer and other chronic diseases. The Canadian Partnership for Tomorrow Project (CPTP) is the first national database designed to both document and follow the health of hundreds of thousands of Canadians for decades to come. CPTP seeks to better understand the complex pathways of disease, and is aimed at improving health outcomes for the next generations. CPTP is the largest research database ever built in Canada, comprising harmonized information from five regional population health studies. Participants were recruited from British Columbia, Alberta, Ontario, Quebec and the Atlantic provinces. Dr. Catherine Boileau is the Director of Epidemiology at CARTaGENE, CPTP’s Quebec partner. She says the database offers researchers an opportunity to focus on analyzing data rather than starting from scratch to set up studies and recruit participants. Researchers have access to a wealth of biological and health data through a simple online request process. “Collecting information, collecting biological material and physical measurements costs a lot of money,” Dr. Boileau notes. “Gaining access to this resource saves money and time. Instead of having to collect data, recruit people and process biological material, researchers can now access the high-quality biological material they need [through CPTP].” Study participants are between the ages of 30 and 74, and have volunteered to provide updated health information over the course of their lives. They come from varying socio-economic backgrounds, and live in both large urban centres and remote rural towns. All have volunteered to fill out a baseline survey that includes detailed questions on their medical history, diet and lifestyle. They have also agreed to link their questionnaires and any bio-specimens with information from electronic health records. Nearly half of CPTP participants have provided blood samples that can be used for biochemical research. There are also 100,000 urine samples, as well as 45,000 blood spots and saliva samples that are additional sources of DNA. CPTP bio-samples also include more than 30,000 toenail clippings that can be tested for environmental exposure to toxins. “Researchers now have at their fingertips a valuable resource they can use,” says Dr. Trevor Dummer, co-leader of the West Coast’s regional population study, the BC Generations Project.  He notes the national sample size represents about one in 50 Canadians within the CPTP’s age group. “We have gathered a lot of information on a large proportion of Canadians. Now that the infrastructure has been created, it is going to accelerate the speed at which we can do research studies.” Accelerated research into the risk factors for cancer is of particular urgency. Despite important advances made in recent decades, cancer remains a formidable adversary for those looking for new prevention strategies and treatments. The disease is complex, unpredictable, and the leading cause of death in this country. As Canada’s population ages, cancers are expected to become even more prevalent, and are forecast to rise by about 40 per cent by the year 2030. CPTP offers a unique window into the genetic make-up and health of people from across the country. It has significant statistical power to explore how genetic predispositions and environment can influence cancer risks. The database gives researchers a new opportunity to scale up their work to include more data from Canadians from diverse geographic regions. “You can test out whether a particular hypothesis in one province may hold true in other populations,” Dr. Dummer says. He points to a research project he and his colleagues are pursuing in B.C., on how urban development can impact people’s health in Metropolitan Vancouver. With CPTP, there is potential to expand the study to include people from other regions of the country. “You can see whether health outcomes in British Columbia hold true for the Prairies. It effectively enables us to do a number of cutting-edge projects.” CPTP is still considered a young population health research study. Its greatest value, according to Dr. Boileau and other researchers, may well be found in the years and decades to come. As the regional population health studies return to their participants for updates, the new information gathered might help shed light on why some people develop cancer and other chronic diseases while others don’t. “We are just beginning. We plan to follow participants for many years, and the study will become more valuable with time,” says Dr. Boileau. “We will be able to compare people who were exposed to different risk factors, and at what rate they develop these diseases.” Dr. Boileau adds that as researchers return the findings of their studies to the cohorts, they will enhance the quality of the data. The more researchers use the database, the more questions CPTP might be able to help answer. The door is now open for independent investigators to use this new national resource – one that holds great potential for scientific discovery.

Canadian volunteers in national study do their part in fight against cancer and chronic diseases (Originally Published on National Post) A new population health study has garnered the unprecedented support of Canadians from coast to coast. The Canadian Partnership for Tomorrow Project (CPTP) has recruited more than 300,000 volunteers to be part of a promising national research platform. Participants have agreed to have their health followed in the coming decades to help in the fight against cancer and other chronic diseases. The volunteers for the study are between the ages of 30 and 74, and include Canadians from many different walks of life. They have offered to provide information about their health, medical history and lifestyle for the CPTP health database. More than half of the volunteers have also offered blood samples for analysis. For some participants, the battle against cancer is deeply personal. Wayne Matthews, a retired electrician living in Fort McMurray, Alta., joined the study in 2012. Cancer has struck many of his family members, including his mother, wife and eldest son. “I just felt it was important to me,” he says. “I don’t want to see other people lose family members. There is so much research going on, and I am hoping this project can dovetail with some of the cancer treatments to make them more effective.” The year 2010 was particularly difficult for the Matthews family. Wayne’s son, Nathan, had a passion for skateboarding and was a talented graphic artist. When he was diagnosed with testicular cancer in 2009 at the age of 28, it came as a shock to family and friends. Nathan, who had proposed to his girlfriend from his Vancouver hospital bed, died in February of 2010. “He was always helping out,” his father remembers. “He had badgered the city council in Williams Lake, B.C., to get a skate park built when he was a teenager. They ended up renaming the skate park in his memory.” Just months later, in July 2010, Wayne’s wife of more than 30 years also passed away. Kathy Matthews was undergoing treatments for multiple myeloma, a form of bone marrow cancer.  Kathy and her son were among an estimated 75,000 Canadians who lost their lives to cancer in 2010 alone. Today, cancer continues to be the leading cause of death in this country, taking the life of one in four Canadians. In an effort to learn more about this and other complex diseases, beginning in the 1990s several provinces launched regional population health studies that followed participants over an extended period of time. CPTP was initiated in 2008 as a collaboration between five of these regional studies in an effort build a large collection of data that are consistent and comparable across the country. Now that the recruitment of volunteers is complete, researchers can delve deeper to address key questions around why cancer takes hold in some people and bypasses others. Most participants in the study were recruited when they were cancer-free and have agreed to provide regular health updates for decades to come. Most have also consented to allow CPTP to access relevant information from their health records through the regional studies. Bringing together information from participants with data from their health records gives researchers a powerful tool to observe possible connections between environmental exposures, lifestyle and the development of disease. “One of the things about these studies is they have to be very large,” says Dr. Heather Bryant, vice-president of cancer control with the Canadian Partnership Against Cancer, noting that CPTP’s participants comprise about one in 50 Canadians in the target age group. “You have to have a big enough study group that you can compare, for example, people who develop colorectal cancer with people who don’t.” Crystal Ormond of Calgary joined CPTP along with her husband in 2014. The 39-year-old emergency nurse has seen cancer take the lives of relatives. She has also witnessed friends and co-workers fight back and beat the disease. “It seemed like a really interesting study to be part of,” she says. “I think it is important, as everyone is touched at some point by cancer. It is a diagnosis where everything just stops.” Ormond was approached to volunteer for the project at a public flu clinic and decided to sign up. She plans to stick with CPTP and fill out new questionnaires over time as they are mailed to her. As the mother of two young boys, she hopes CPTP can help shed light on the triggers for cancer and find ways to better prevent and treat the disease in the future. “It seems like more and more people are getting cancer,” she observes. “Are there things we are doing in our environment, or things we can change to reduce the risk? I think that would be great to figure out, why some people get cancer and others remain healthy throughout their lives.” Wayne Matthews also sees reason for hope in this initiative and other medical breakthroughs. He has lost so much, and looks forward to a day when cancer does not leave such a devastating imprint on families and communities. “I see articles out there about new treatments, gene therapies and targeted treatments,” he says. “I look at the progress that has been made even in the short time since 2010 and I think, yeah, we are headed in the right direction. We just need to take it all the way.”

Unlocking the mysteries of cancer and other chronic diseases (Originally Published on National Post) Why do people who live in British Columbia have lower cancer rates than those who live in the Atlantic provinces? How can we detect cancer earlier, and reduce the risk of developing the disease? These are just some of the questions at the heart of an ambitious national project that aims to better understand the causes of cancer and other chronic illnesses. In a national collaboration known as the Canadian Partnership for Tomorrow Project (CPTP), research teams across Canada have recruited volunteers from a wide cross-section of society to participate in a long-term population health study. CPTP is the largest data collection of its kind in Canadian history. More than 300,000 people between the ages of 30 and 74, living everywhere from urban centres in British Columbia to remote villages in Newfoundland, have signed on to have their health followed over the course of their adult lives. “This is not your typical clinical research. Participants are acting as citizens, as representatives of the Canadian population, and creating a resource of data and samples to be used by more disease-specific researchers over time,” notes Prof. Bartha Maria Knoppers, director of the Centre of Genomics and Policy at McGill University and one of the socio-ethical and legal architects of CPTP. “There is no direct personal benefit, but they are proud to be contributing to the health of future generations.” CPTP volunteers have provided researchers with personal health information in a range of areas. They were asked about their education and ethnic background, as well as their medical history, level of physical activity, and alcohol and tobacco use. Nearly half of the participants have also provided blood samples, and all have agreed to be contacted in the future to provide regular updates on their health. This long-term, observational data helps medical investigators establish links between risk factors and health outcomes.