Calgary clinic emerges as a research leader in Canada’s battle against colon cancer

A woman in her '50s enters a building on the University of Calgary’s Foothills campus, making her way up an elevator and through open doors to the waiting room of the Forzani and MacPhail Colon Cancer Screening Centre. After filling out a short questionnaire on her health and lifestyle, she has joined one of the largest research projects in Canada, designed to improve the early detection and prevention of colorectal cancer.

Researchers at the Arnie Charbonneau Cancer Institute, a joint institute of the Cumming School of Medicine (CSM), Cancer Care Alberta and Alberta Health Services, are gathering data from more than 20,000 participants like her. They are investigating the characteristics that could personalize risk prediction and screening pathways and help develop the next generation of screening tests.

The Forzani and MacPhail Colon Cancer Screening Centre is a clinical leader in colorectal cancer screening. Through this research and other projects, it has emerged as a leading research facility in the country.

Focus on understanding who is at higher risk 

“Our goal is to improve screening for colorectal cancer and, ultimately, patient outcomes,” says Dr. Robert Hilsden, MD, PhD'01, MSc'96, the research director of the centre. “First, we want to better understand who is at high risk for colorectal cancer and who is not, so we know who needs to be screened and how best to do it. Second, we want to improve the screening experience to maximize participation.”  

The team is building unique repositories of data that include the collection of biospecimens (blood, urine, normal colon tissue) and detailed information about the participant’s medical history, lifestyle, physical activity and diet. Most of the participants, 75 per cent, in the Charbonneau Institute study are between 50 and 64 years of age.

“More than ever before, this research is allowing us to use data science and advanced analytics to understand cancer risk,” says Dr. Darren Brenner, PhD, the associate research director of the centre.

Bend the curve and reduce cancer burden

“From this work we can develop and advocate for improved policy, practice and personal change to bend the curve and reduce cancer burden in Canada. The work has the potential to save lives and have a positive economic impact, as we reduce the need to access the health-care system.”

Brenner is leading research to understand why colorectal cancer is increasing at a steep rate in young men and women, and to predict the impact of reduced screening during the COVID-19 pandemic.

Researchers at the facility also conduct clinical studies focused on improving colorectal cancer screening and colonoscopy. The high volume of patients, more than 17,000 each year, and standardized clinical pathways and processes enable large clinical studies that would be impossible to perform at a busy hospital endoscopy unit.

The centre’s medical director, Dr. Steven Heitman, MD'00, MSc'12, has led the development of colonoscopy upskilling courses and animal simulation models of polyp removal, driving improvements in colonoscopy quality provincially and nationally.

Canada’s third most common cancer

Colorectal cancer is expected to be the third-most commonly diagnosed cancer in Canada in 2020, according to the Canadian Cancer Society. It is the second leading cause of death from cancer in men and the third leading cause of death from cancer in women in Canada.

Colorectal cancer generally develops when mutations in certain genes cause cells to continue dividing even when new cells aren't needed. This unregulated growth can cause polyps to form which can turn into cancer over time. Early detection of polyps and colorectal cancer through screening asymptomatic individuals reduces the risk of death.

Known risk factors include a personal or family history of colorectal cancers or polyps. Lifestyle factors such as increased body mass index, cigarette smoking, drinking alcohol, eating red meat, low dietary fibre intake, and low physical activity have been shown to increase risk.

Community builders identify the opportunity to improve lives

Philanthropists John Forzani and Keith MacPhail saw an opportunity to help thousands of Albertans and they acted.

Through a joint fundraising initiative of Alberta Health Services (then named the Calgary Health Region) and the University of Calgary, The Forzani Group Foundation and the MacPhail Family donated more than $2.7 million toward the centre that today bears their name. It remains the only publicly funded centre in Canada dedicated to colorectal cancer screening, combining comprehensive screening and advanced therapeutics to provide southern Albertans with cutting edge care.

Located in the Teaching, Research and Wellness Building at UCalgary’s Foothills campus, the facility occupies 23,000 square feet and features six endoscopy rooms, three reprocessing rooms, 24 recovery beds, six nurse-clinician pre-assessment rooms, a theatre for public and professional educational activities and research facilities.

Since 2008, the centre has performed more than 170,000 colonoscopies.