Charbonneau researchers receive funding from CIHR

Improving Quality of Care: Head and Neck Cancer Focus

The burden of disease for Head & Neck Cancers on patients and the healthcare system is substantial. Head & Neck Cancers are the 7th most common type of cancer with a 5-year survival rate of only 50%. Treatment for Head & Neck Cancer is multimodal, often including major surgery that is among the most challenging and resource intensive interventions in our healthcare system. Head & Neck Cancer surgery can also have long-lasting consequences on a patients’ functional status (e.g., impaired speaking and swallowing). Evidence suggests care for these patients is of varying quality. Adopting evidence-based care has been shown to improve the quality of care (the right care, for the right person, at the right time), which improves the health of patients. However, little is known about the quality of care provided to Head & Neck surgical oncology patients and the effect on health outcomes.

The Ohlson Research Initiative’s Drs. Khara Sauro and Joe Dort will leverage large, administrative health data sources to effectively and efficiently measure the quality of Head & Neck Cancer surgical oncology care and its effect on process of care (including healthcare resource) and clinical outcomes. This study is the foundation for a larger research program that will design and implement interventions to improve the quality of care for Head & Neck Cancer surgery patients. It will involve linking data from the Discharge Abstract Database, National Ambulatory Care Reporting System, physician billing claims, population utilization cost database, diagnostic imaging, Alberta Cancer Registry, eCritical (ICU-specific repository) and Otobase™ (prospective Head & Neck Cancer surgery database). They will use these data to produce a valid and reliable case definition to identify Head & Neck Cancer surgical oncology and then examine the relationship between quality of care and clinical outcomes (mortality and cancer reoccurrence), including congruence of current care with evidence-recommended care, safety of care, resource utilization, and variation in care. This study will establish an accurate method of identifying Head & Neck surgical oncology patients in administrative health data, guide appropriate allocation of healthcare resources for these patients and fuel future research aimed at improving the care for Head & Neck Cancer surgery patients. Their team is ideally positioned to disseminate our research and make meaningful improvements to the care of these patients because of our partnership with leaders and decision makers.

Reducing Cancer Risk: Breast and Lung Cancer Focus

Epidemiologic studies of the association between vitamin A intake and cancer risk have been inconsistent and limited. Most studies have failed to find significant associations between vitamin A intake and cancer risk. However, a recent study has shown that higher intake of vitamin A may be associated with a lower risk of skin cancer. The authors argued that a much larger cohort was needed to see the effects of vitamin A in reducing cancer incidence. This means that only small fraction of individuals could gain benefits of vitamin A in reducing cancer incidence. Nature Killer (NK) cells not only exert cell-mediated cytotoxicity against tumor cells or infected cells, but also act to regulate functions of other immune cells by secretion of cytokines and chemokines, thus providing surveillance in early defense against viruses, intracellular bacteria and cancer cells.

Dr. Edwin Wang of the Childhood Cancer Research Program and his team recently found that if an individual has more NK cell defective (pathogenic) germline genes, he/she could have a higher risk of developing cancers. Since vitamin A is able to activate NK cell activity by regulating NKG2D activating receptor on the surface of NK cells, they hypothesized that higher total vitamin A intake in individuals who have more NK-cell defective genes (or low NK cell activity) could see a reduction in cancer risk. To test this hypothesis, Dr. Wang and his team are will use population cohorts to identify the participants who have more pathogenic NK cell-specific genes based on the whole-exome sequencing data, and then investigate the association of vitamin A intakes between breast/lung cancer risk and higher NK cell defective gene participants. In the past, nutrient-cancer risk association studies have been conducted by examining a general population only. The project design here provides a paradigm shift for studying nutrient-cancer risk association in a targeted population setting, and could lead precision prevention which will be a conceptual leap in the field.        

Both grants were funding by CIHR as operating grants through the Data Analysis Using Existing Databases and Cohorts funding opportunity.