Marie-Elise Parent

Workplace exposures and prostate cancer: analysis and reporting on a Canadian population-based study

Principal investigator: Marie-Élise Parent

Collaborators: Paul Demers, Jérôme Lavoué, Marie-Claude Rousseau, Andrea Benedetti, Cheryl Peters

Funding: CIHR

Years: 2018-2022

Rationale: Each year, 21,000 Canadian men are diagnosed with prostate cancer (PCa). About 30% of these are aggressive but diagnosis and treatment of non-aggressive ones seriously impact quality of life. Age, ancestry and family history are the only established risk factors while genetics explain only a proportion of familial cases. There is compelling evidence that environmental factors play a role, but modifiable risk factors have yet to be identified so prevention has not been possible. Other than for pesticides, very little research has been conducted on environmental chemicals in PCa etiology. Several chemicals are themselves carcinogens or act as hormone modulators, and could be implicated. The workplace represents a preferential window to study these since many are encountered there at higher levels, facilitating their measurement. Since most workplace chemicals eventually make their way into the general environment, such exposures are not only relevant to workers but also to the entire population. The absence of large occupational studies benefiting from strong exposure assessment has been the major drawback to advancing knowledge in this area. In 2002-2015, Canadian funding agencies funded what is to our knowledge the largest and most comprehensive population-based study of PCa, to assess the etiological role of workplace exposures. The occupational assessment was completed, as planned, in late 2015, coinciding with the end of funding, and it was anticipated that new funding would need to be secured for primary analyses. CIHR funding is sought at this time to leverage this large effort and investment, and carry out primary analyses and report on this unparalleled Canadian resource.

Broad goal: To investigate whether different exposures measured in the workplace increase the risk of developing PCa.

Methods: 1,933 cases, including 538 aggressive cancers, were ascertained from Montreal metropolitan area hospitals. Concomitantly, 1,994 population controls were selected from electoral lists. Face-to-face interviews collected information on socio-demographic, lifestyle and medical factors, including screening. We documented each job held by each subject over his lifetime, eliciting details on specific tasks, equipment used, etc. This wealth of occupational information (15,724 job descriptions) has been coded by a team of chemists/industrial hygienists into lifetime exposure to hundreds of chemicals.

Aims: This protocol outlines 19 analytical subprojects to be undertaken over the course of the grant. It focuses on suspected exposures with hormone-modulating properties and/or previous evidence such as polycyclic aromatic hydrocarbons, petroleum-derived liquids, engine emissions and combustion products, solvents, welding fumes, resins and polymers, metals, painting-related chemicals, and pesticides. Other projects focus on night work and on physical activity/inactivity at work. Exposures will be analysed individually and combined, taking into account co-exposures, confounding and interactions.

Core expertise: We propose here an exciting, innovative and far-reaching data analysis project, benefiting from a solid expertise in occupational epidemiology, exposure assessment and biostatistics, and involving trainees.

Significance/application: This project, representing a major advance in the field, will generate important new knowledge towards the establishment of preventive measures against PCa.

Occupational exposure to chemicals among females: improving on a job-exposure-matrix to provide exposure estimates according to sex

Principal investigator:  Vikki Ho

Collaborators:  France Labrèche, Jérôme Lavoué, Jack Siemiatycki, Marie-Élise Parent

Funding: IRSST

Years: 2018-2020

Problématique de santé et de sécurité du travail et objectifs: Les femmes constituent près de la moitié de la population active au Québec. Pourtant, la plupart de nos connaissances sur les maladies professionnelles proviennent des études réalisées chez les hommes. Dans une étude financée par l’IRSST, une analyse des expositions aux contaminants chimiques et physiques a révélé des différences d’exposition entre les hommes et les femmes à l’intérieur de plusieurs professions. L’absence d’information fiable concernant les expositions professionnelles chez les femmes représente un défi qui limite l’évolution de nos connaissances dans le domaine de l’hygiène du travail. Le but de cette activité concertée est d’améliorer la matrice emploi-exposition canadienne CANJEM en y ajoutant des données féminines. CANJEM a été développée à partir de la synthèse des évaluations de plus de 30 000 emplois occupés par 9 000 hommes et femmes par des experts chimistes et hygiénistes industriels. La matrice CANJEM comprend l’estimation de la probabilité, de l’intensité et de la fréquence des expositions à 258 agents, dans différentes périodes de temps. CANJEM utilise quatre systèmes de classification professionnelle (CCDO7D, ISCO68, SOC2010, NOC2011) et trois systèmes de classification industrielle (ISIC71, SIC80, NAICS2012). Selon le recensement canadien de 2011, les femmes représentent 48 % de la population active employée, alors que 26 % des emplois inclus dans CANJEM étaient occupés par des femmes, ce qui limite la capacité de CANJEM à fournir des évaluations d’expositions chimiques différenciées selon le sexe. Ce projet vise à ajouter des données d’exposition féminines à CANJEM pour remédier à cette limite. Objectif 1: Effectuer l’évaluation d’expositions, par des experts, de 4,119 descriptions d’emplois provenant des histoires professionnelles de participantes à une étude épidémiologique montréalaise. Objectif 2: Intégrer ces nouvelles évaluations à CANJEM pour améliorer sa capacité à fournir des évaluations d’expositions professionnelles chez les femmes. Objectif 3 : Fournir des données sur les expositions professionnelles des Montréalaises.

Méthode: Pour cette activité concertée, nous proposons d’utiliser les données professionnelles d’une étude cas-témoins sur le cancer du sein ménopausique à Montréal. Cette étude a utilisé la même methodologie que les études originales qui ont contribué à construire CANJEM. La nouvelle population d’étude pour laquelle les 4,119 descriptions d’emplois sont disponibles comprend 1,297 femmes entre 50 et 70 ans  interrogées sur leur historique professionnel complet. Nous utiliserons une méthode d’expertise développée par notre groupe de recherche et reconnue mondialement pour évaluer les descriptions de tâches détaillées et assigner l’exposition concernant les 258 agents inclus dans CANJEM. Nous intégrerons  ensuite les nouvelles données à CANJEM pour permettre une évaluation différenciée selon le sexe.

Résultats attendus: Cette activité augmentera la capacité de CANJEM à fournir une information fiable sur l’exposition chez les femmes, applicable à une large gamme de professions et de secteurs d’activité économique au Québec et au Canada.

Retombées prévisibles: Il existe peu d’information sur la relation entre le sexe et l’exposition professionnelle. Cette étude apportera une contribution importante à la santé en fournissant un portrait récent des expositions professionnelles chez les travailleuses au Québec. L’amélioration de CANJEM permettra de mieux surveiller les milieux de travail pour l’établissement des priorités de recherche et d’intervention, et de façon plus générale d’appuyer les programmes pour la prévention des maladies professionnelles.

Potential predictors of prostate cancer development

Principal investigator: Marie-Élise Parent

Collaborators: Géraldine Delbès

Funding: Cancer Research Society

Years: 2018-2019

There are as yet very few known predictive factors of prostate cancer development. Age, family history and ancestry are the only ones clearly established and these are currently used to orient detection efforts. Major scientific progress would be achieved if we could identify additional predictors of prostate cancer as a whole, and of aggressive cancers more specifically. The present proposal focuses on three innovative, potential predictive factors of prostate cancer and aggressiveness that have been shown to reflect past hormonal exposures: (1) baldness and chest hair patterns; (2) the ratio of the lengths of the 2nd to the 4th finger (digit ratio or 2D:4D); and (3) fertility and fatherhood.

To achieve this, we will carry out the primary statistical analysis of data collected as part of PROtEuS, a vast population-based case-control study conducted in Montreal in 2002-2015. In brief, 1,933 cases of prostate cancer, including 538 aggressive cancers, and 1,994 population controls were recruited. As part of in-person interviews, trained interviewers elicited details on a wide range of personal socio-demographic, environmental, lifestyle and medical factors. Using the validated Hamilton-Norwood classification system, participants indicated baldness patterns at 10-year increments starting at age 30, and described their chest hair pattern. A group of questions centered on infertility, and on the number of biological children fathered. Interviewers measured finger lengths according to a standardized protocol in order to calculate Manning’s index, i.e., the ratio of the lengths of the second and fourth digit (2D:4D). Logistic regression models will be developed to evaluate associations between the three sets of potential predictive factors and prostate cancer risk, for all cancers and by disease aggressiveness. Possible confounders and effect modifiers, specific to each factor studied, will be identified and taken into account.

Despite extensive research, identifying men who are at higher risk of developing prostate cancer, especially its aggressive form, remains a major challenge. Should the proposed research identify predictors of risk, our findings would be of high clinical significance. These, in conjunction with other clinical tools, could help targeting detection efforts in higher-risk populations, which in turn, would lead to earlier-stage diagnoses and improved prostate cancer management.

Impact of genome-wide and local homozygosity on cancer

Principal investigator: Marie-Élise Parent

Co-Principal investigator: Kelly Burkett

Funding: CIHR, Secondary data analysis for cancer prevention and control

Years: 2018-2019

It is well known that homozygosity causes rare, often very severe, Mendelian diseases. However, the health impact of increased homozygosity levels on complex traits is not well understood. Recently, a very large study, published in Nature and including >300,000 individuals from >100 cohorts, reported increased homozygosity levels to be associated with complex traits including height and cognitive ability. Most human populations display restricted ranges of homozygosity levels, yielding low power for studies investigating how homozygosity relates to complex human traits including cancer-related traits. Our project will take advantage of the higher homozygosity levels present in the Quebec founder population combined with accessible larger datasets available from dbGaP to study the contribution of global and local homozygosity levels on prostate cancer traits. Our objectives are to: 1. Develop a novel approach to estimate homozygosity by descent (HBD) based on ancestral trees; 2. Quantify genomic homozygosity in the participants of the different datasets and relate it to cancer-related traits; 3. Assess how local vs. global homozygosity shape the homozygosity-trait relationships and contribute to the total variation in prostate cancer traits. Large founder populations such as Quebec allow the measurement of a wide range of HBD levels and are thus ideal to efficiently study homozygosity and its impact on cancer-related traits. However, study samples from founder populations are often smaller. A solution is to combine samples from founder populations to those from larger outbred population, allowing the measurement of a wide range of homozygosity levels. We propose to combine data from the ongoing Montreal-based PROtEuS study of prostate cancer to large prostate cancer datasets accessible through dbGaP, thus allowing us to increase our power to characterize homozygosity-phenotype relationships by increasing both sample size and variation in homozygosity. We will first develop a novel method to estimate HBD based on ancestral trees that has the potential to better capture individual ancestries. We will use this new method in conjunction with existing methods to quantify HBD levels. We will then use generalized linear models to study the association between HBD levels and cancer-related phenotypes, considering both global and local HBD and their respective contributions to prostate cancer traits. Animal studies have shown that non-additive genetic variation (underlying homozygosity effects), can be as important as additive genetic variation in shaping complex traits, but the latter is most often studied. Our research will thus provide insights on non-additive genetic effects for important cancer-related traits and could ultimately result in better health management of these traits.

Social deprivation and environment, and risk of prostate cancer

Principal investigator: Marie-Élise Parent

Collaborators: Amélie Quesnel-ValléeGeetanjali Datta, Yan Kestens, Tracie Barnett, Belinda Nicolau, Andrea Benedetti

Funding: Canadian Cancer Research and Canadian Institutes of Health Research

Years: 2017-2019

Problem:  Social isolation has been defined as a lack of participation in social relationships and/or lack of interaction with others and/or with society at large. Socially deprived individuals experience poorer health outcomes, including greater cancer-specific mortality and poorer prognosis for some cancer sites, including the prostate. Social deprivation has also been linked to cancer. Surprisingly, hardly any research has evaluated whether it relates to prostate cancer incidence more specifically. As social environments can facilitate or impede resource sharing, reinforce health beliefs as well as health behaviors, social environments would be expected to influence the entire prostate cancer spectrum, including its incidence and prevention.

Objective: To explore, for the first time, the association between several demonstrated or suspected indicators of social deprivation (or lack thereof), and the risk of developing prostate cancer. These will be assessed both at the personal and neighbourhood levels, and at several time points over the lifecourse.

Methodology: The proposed analyses will be conducted on a vast, already assembled Canadian dataset, which will be augmented with additional relevant data. Between 2002 and 2015, the Canadian Cancer Society and the Cancer Research Society funded the largest ever and most comprehensive population-based case-control study of prostate cancer to elucidate its causes. It comprises 1,933 cases prostate cancer cases, including 538 aggressive cancers, and 1,994 population controls.

As part of extensive in-person interviews, trained interviewers elicited details on a wide range of personal socio-economic, demographic, environmental and lifestyle factors. Some of these factors, such as being a widow or living alone, are recognized indicators of social deprivation. Many others, including the family size and structure, can be suspected to reflect the potential for social interactions and have never been studied with respect to prostate cancer risk. Detailed lifetime job descriptions (n=16,095) will inform us on workplace characteristics and their social environment, as well as on the influence of job mobility and work schedules. Lifetime residential addresses (n=13,073) have been geocoded and will be linked to neighbourhood-level indicators of social deprivation. Lifetime addresses will also be used to document the frequency of changes in residential environment and the distance between moves.

Statistical analyses will describe the association between prostate cancer on the one hand, and the various personal and neighbourhood-based indicators of social deprivation, using unconditional logistic regression. Polytomous models will seek out associations by cancer aggressiveness. For factors for which we have information over several time points over the lifetime, we will apply lifecourse analytical approaches to test critical period vs. accumulation models. The availability of detailed information on lifestyle factors at the individual level will enable us to evaluate potential confounders and mediating factors. The role material deprivation, as well as of prostate cancer screening practices, in observed associations will also be investigated.

Significance: In light of the large prostate cancer burden and complete absence of strong leads for prevention, it is essential to cover new grounds to identify factors amenable to intervention. Building on a recently assembled Canadian database, this study covers several unexplored areas and will provide entirely novel evidence on the role of social deprivation in prostate cancer incidence. Should an association be demonstrated, this would represent a major advancement towards cancer prevention. This research can indeed provide insights into prostate cancer disease processes, identify vulnerable populations, and generate results with translational impact of relevance to interventionists and policy makers.

Occupational physical activity and lung cancer risk

Principal investigator: Vikki Ho

Co-Principal investigator: Anita Koushik

Collaborators: Michal Abrahamowicz,Coraline Danieli, Anne Grundy, Jérôme Lavoué, Marie-Élise Parent, Jack Siemiatycki

Funding: Canadian Institutes of Health Research

Years: 2017

Globally, lung cancer remains the leading cause of cancer death in men and women. Given the limited treatment options, the identification of modifiable factors for primary prevention of lung cancer is necessary to reduce the burden of this deadly disease. Research supports that increasing physical activity (PA) reduces the risk postmenopausal breast cancer and colon cancers. For lung cancer, a recent meta-analysis indicated that regular recreational PA may be associated with a 24% reduced risk. However, PA is also derived from occupational, household and transportation-related activities, among which perhaps the most important is occupational, as most people spend many hours at work, and some jobs entail considerable PA. Few studies have examined occupational PA in relation to lung cancer risk and the results are inconclusive with some evidence even supporting a positive association. In most of these studies, the assessment of occupational PA was crude. As well, the existing literature likely suffers from uncontrolled confounding by occupational co-exposures to lung carcinogens as many jobs with high levels of PA are potentially those that have concurrent exposure to lung carcinogens. In Canada, occupational PA contributes greatly to total PA in Canadians; though it is not easily modifiable, if an important protective association is found between occupational PA and lung cancer then this can inform public health measures, for instance by increasing activity by other means (i.e. recreational, transportation). Alternatively, if, similar to a few previous studies, increased risks are found with higher PA, then this would support further investigation into mechanisms associated with different types of PA and/or potential harmful exposures that may co-occur with highly physically active jobs.

OBJECTIVES: The primary objective of this study is to investigate the relationship between occupational PA levels and lung cancer risk. The associations will be examined for men and women separately. In addition to studying lung cancer as a whole, the main histological types will be considered (i.e. adenocarcinoma, squamous cell carcinoma and small cell carcinoma). In secondary analyses, we will explore whether the relationship between occupational PA and lung cancer risk varies by exposure to occupational lung carcinogens

METHODS: This research will be conducted among individuals enrolled in the Canadian Partnership for Tomorrow Project (CPTP), a population health research platform that contains data from more than 300,000 Canadians aged 35-69 at the time of enrolment (2009). We will include all participants with an incident diagnosis of lung cancer during a follow-up period from baseline to 2015 (estimated N=1989). A sub-cohort of 2000 individuals will be randomly sampled from the entire CPTP cohort at baseline. All participants with a history of cancer (other than non-melanoma skin cancer) at baseline will be excluded. At baseline, participants of CPTP provided detailed information on their longest-held job, including job title, industry, and age at which the job started/ended. To assign metabolic equivalent of tasks (MET) to the longest-held job, we will use data generated by our team on the energy expenditures associated with almost 3600 job titles. Briefly, in a series of case-control studies conducted by our team, experts evaluated participant job histories and their main job-related tasks, and determined energy expenditure in METs using the Compendium of PA as a reference. Potential confounding by occupational lung carcinogen exposure is a major factor, thus, to determine exposure to lung carcinogens in the longest-held job, the Canadian job exposure matrix will be used. A weighted Cox proportional hazards regression model will be used to estimate adjusted hazard ratios and 95% confidence intervals for the association between occupational PA in the longest-held job and lung cancer risk, separately for men and women. Occupational PA will be conceptualized as both continuous and categorical variables; categories will be based on tertile cutpoints among the subcohort. In secondary analyses, potential modification of the occupational PA-lung cancer relationship by exposure to occupational carcinogens will be

analyzed through the inclusion of specified multiplicative interactions, whose joint contribution will be tested using a likelihood ratio test.

CONTRIBUTION: This research will inform on the role of occupational PA in the primary prevention of lung cancer based on one of the largest cohorts ever assembled in Canada.

Bacillus Calmette-Guerin (BCG) vaccination and multiple sclerosis: a population-based study in Quebec

Principal investigator: Marie-Claude Rousseau

Collaborators:   Christina Wolfson, Andrea Benedetti, Marie-Élise Parent, Nathalie Arbour, Pierre Duquette

Funding: Multiple Sclerosis Society Of Canada (MSSOC), CIHR

Years: 2015-2018

Multiple sclerosis (MS) is an inflammatory and neurodegenerative disease of the central nervous system. MS is the leading cause of non-traumatic disability among young adults, and thus has important individual and societal impacts. The causes of MS are not known, but some environmental factors have been associated with disease risk such as place of birth, sex, race, smoking, Epstein Barr Virus (EBV) exposure, and vitamin D exposure through sun and diet. It is generally recognized that the immune system is directly involved in the pathophysiology of MS. In this sense, factors having an impact on the immune system are good candidates to investigate in relation to MS etiology, as either beneficial or harmful agents.

In this project, we focus on the Bacillus Calmette-Guerin (BCG) vaccine and its potential immunomodulatory role on MS development. Only six epidemiological studies to date have addressed BCG vaccination and the risk of developing MS. A meta-analysis on immunizations and MS, suggested a lack of association between BCG vaccination and MS, but these studies presented limitations such as limited sample size, use of questionnaire data to define BCG status, and extreme proportions of vaccination (very low or very high). Considering these limitations, there is a need for a methodologically sound and well-powered study on early life BCG vaccination and risk of MS. Quebec is a uniquely appropriate setting for such a study, since a province-wide BCG vaccination program was held between 1949 and 1974, and vaccination information was compiled in a registry.

Our main objective is to determine whether BCG vaccination is associated with the risk of multiple sclerosis. As a secondary objective, we will assess the impact of age at BCG vaccination with a particular interest in vaccination during the first year of life.

We will expand an existing population-based cohort, the Quebec Birth Cohort on Immunity and Health (QBCIH), originally designed to assess non-specific effects of BCG vaccination on inflammatory and autoimmune diseases. Established through probabilistic record linkage of provincial birth, death, and BCG vaccination registries, as well as administrative databases, the QBCIH includes 81,496 persons, representing 90.5% of those born in Quebec in 1974 at or after 32 weeks of gestation. For this project on MS, we will substantially augment the study population size and duration of follow-up. We will assemble a large retrospective cohort of individuals born from 1970 to 1974, in which the QBCIH will be included. Data will be gathered from administrative databases until 2013, and will include sociodemographic and perinatal factors, information on death if applicable, BCG vaccination, as well as data on medical services and hospitalizations for MS. A validated definition based on use of health services will be applied to identify MS cases.

This project constitutes a creative approach to studying MS etiology, a crucial aspect for prevention given the few known modifiable causal factors. By studying an existing vaccine which could contribute to MS prevention through a non-specific effect, this project can have tangible repercussions in MS prevention.

Impact of Bacillus Calmette-Guerin (BCG) vaccination on the risk of lymphoma

Principal investigator: Marie-Claude Rousseau

Collaborators: Andrea Benedetti, Marie-Élise Parent

Funding: Candian Cancer Society Research Institute (CCSRI)

Years: 2015-2018

BCG vaccination was used in Quebec until 1974 to prevent tuberculosis. The goal of Dr. Marie-Claude Rousseau’s research is to understand other effects that BCG vaccination could have on various diseases. In this project, our team will evaluate if having received the BCG vaccine as a child could prevent lymphoma later in life, as it was suggested by a study conducted in Denmark. We have recently created a cohort of 81,496 persons born in Quebec in 1974 by linking several sociodemographic and medical databases. We will obtain information on medical visits and hospitalizations related to lymphoma until 2013. We will then compare the occurrence of lymphoma among persons who received the BCG vaccine and those who did not. Only a few epidemiological studies were conducted to investigate the effect of BCG vaccination on the risk of developing lymphoma. These studies had methodological problems that do not allow concluding on this question. Some were too small, and others had many participants who left the project before the study was over. In most studies, information about BCG vaccination was reported by the participants instead of coming from health records, which is usually more accurate. Age at vaccination was never considered, but it should be. The effect of BCG on lymphoma could be different if the vaccine was given very early or later in life. A recent study, well designed but small, suggested that persons who received the BCG vaccine were 50% less likely to develop lymphoma than those who were not vaccinated. In this context, we hypothesize that the BCG vaccine has a protective effect on lymphoma. We designed a study which will allow us to test this hypothesis. The BCG vaccine stimulates some cells from the immune system which may help prevent lymphoma. Our team wants to assess if BCG vaccination is related to the risk of developing lymphoma. The effect of BCG vaccination will also be studied separately among persons who were vaccinated at 0-1 year old or later. We created a cohort of 81,496 persons born in Quebec in 1974 by linking provincial birth, death, and BCG vaccination registries, and databases from the healthcare system. We will use this cohort, called the Quebec Birth Cohort on Immunity and Health, for our project. Information related to lymphoma will be obtained from health databases until December 31 2013, when the subjects were 39 years old. This will include physician billing data for medical visits or hospitalizations. From the Quebec Tumor Registry, we will extract information on diagnosis of lymphoma and other cancers. We will compare the risk of developing lymphoma among those who were vaccinated and those who were not. In this project, we are studying a new factor in relation to the development of lymphoma. By studying an existing vaccine which could contribute to lymphoma prevention, this project can have a real impact on cancer prevention. Given that there are few known causes of lymphoma that people can control, it is important to explore all avenues. The existing Quebec Birth Cohort on Immunity and Health offers a unique opportunity to conduct our project. It provides a solid foundation on which we can build. The study setting offers nearly perfect conditions for studying this novel hypothesis. This project has the potential to greatly impact our understanding of the causes of lymphoma. It can lead to concrete preventive approaches to fight this cancer.

Occupational exposure to silica, diesel and gasoline engine emissions and incident kidney cancer in Canadian men

Principal investigator: Paul J. Villeneuve

Collaborators:  Shelley Harris, Marie-Élise Parent

Funding: Ontario Ministry of Labour

Years: 2015-2017

Silica, diesel and gasoline exhaust are probable cancer-causing agents that are widespread in a variety of industries and are also present in smaller quantities in the natural environment. Approximately 380,000 Canadians are occupationally exposed to silica and 781, 000 Canadians are occupationally exposed to diesel engine emissions; over 90% of these workers are male. Examples of occupations where workers are exposed to silica include construction, mining, and manufacturing. Mining and quarrying, railroad work, forestry and logging, and drivers are examples of jobs where workers are exposed to diesel and gasoline engine emissions.  Health concerns arise when respirable particulates are created during the processing of materials containing silica and use of equipment and vehicles powered by diesel and gasoline engines. While it is known that exposure to these agents in the workplace can negatively affect human health, their effect on cancer remains poorly understood. Much of the existing research has focused on their effect on the respiratory system. This study will examine whether workplace exposure to these agents increases the risk of developing kidney cancer. All jobs held over the lifetime of each study participant will be reviewed by an expert who will describe each job according to the level of exposure and the percentage of time that exposure occurred. Workplace exposure to these agents among a sample of Canadian men who developed kidney cancer will be compared to a group of men who are cancer free. Questionnaire information provided by these participants will allow us to take into account the effects that other factors, such as age, smoking, obesity, and other workplace exposures, may have on the development of kidney cancer. The ultimate goal of this research is to help inform the development of targeted exposure reduction strategies and cancer prevention programs in the workplace.

Quebec Research Program for Prostate Cancer Prevention

Principal investigator: Marie-Élise Parent

Co-Principal investigator: Pierre Karakiewicz

Collaborators: Marie-Hélène Roy-Gagnon, Jack Siemiatycki, Jérôme Lavoué, Eduardo Franco, Armen Aprikian, Michal Abrahamowicz, Fred Saad, Mark Goldberg; Marie-Claude Rousseau, Belinda Nicolau, Anand Chokkalingam , Ann Hsing

Funding: Société de recherche sur le cancer; Enseignment supérieur, Recherche, Science et Technologie de Québec; Fonds de recherche Santé Québec; RRSE; RioTintoAlcan; National Cancer Institute of Canada, Canada Research Society, MDEIE

Years: 2010-2015

We initiated back in 2010, the Quebec Research Program for Prostate Cancer Prevention, which calls upon the collaboration of 12 established Quebec researchers covering environmental, occupational, infectious, lifecourse, molecular and genetic epidemiology, biostatistics and urology. This is probably the largest study ever to evaluate in such depth the possible environmental causes of prostate cancer. In brief, the Program has allowed us to build, on an existing research infrastructure, a major research effort including 12 objectives: (1) recruit 1,000 study subjects to bring the overall study sample of the Program to 4,000 subjects, (2) evaluate the presence of 110 chemicals in the subjects’ workplaces, (3) evaluate  physical activity levels in workplaces, (4) evaluate dietary intakes, (5) collect information on all residences held by the subjects, (6) evaluate whether genetic factors determine how exposure to the environment relates to prostate cancer, (7) analyze hair and toenail samples as biomarkers of exposure to trace metals, (8) evaluate the determinants of prostate cancer progression, (9) create analytical databases, (10) conduct statistical analyses, (11) train students and research personnel, (12) disseminate findings. There are no doubts that with the wealth of information collected in the context of this Program, this collective effort in elucidating risk factors for prostate cancer will last for decades to come.

Occupational and selected nonoccupational risk factors for lung cancer: analysis of a case-control study in Montreal

Principal investigator: Jack Siemiatycki

Co-Principal investigator: Marie-Élise Parent

Collaborators: Michal Abrahamowicz, Bruce Case, Mark Goldberg, Igor Karp, Anita Koushik, Daniel Krewski, Jérôme Lavoué, Karen Leffondré, Marie-Claude Rousseau

Funding: CIHR

Years: 2010-2015

I am leading and participating to projects using data from a case-control study conducted by Jack Siemiatycki and collaborators in Montreal (1996-2002), and aiming to understand the environmental causes of lung cancer. Through student supervision and several collaborations, I am investigating several types of factors, from lifestyle to environmental exposures, in relation to lung cancer risk. For example, some of these projects covered dietary intake of carotenoids and vitamin C, body mass index, socioeconomic status, history of allergic diseases, as well as occupational exposures such as asbestos, formaldehyde, lead compounds, gasoline emissions, and cotton dust.

Non-specific stimulation of the immune function in early age through Bacillus Calmette-Guérin (BCG) vaccination and occurrence of childhood asthma

Principal investigator: Marie-Claude Rousseaus

Collaborators: Andrea Benedetti, Mariam El-Zein, Dick Menzies, Marie-Élise Parent

Funding: CIHR

Years: 2010-2014

I am currently conducting studies looking into a possible link between non-specific stimulation of the immune function in early age, such as that induced by Bacillus Calmette-Guérin (BCG) vaccination, and beneficial or detrimental effects on the development of inflammatory and autoimmune diseases later in life. For these studies, we are using information from the Quebec BCG vaccination registry and linking it to administrative health databases in order to determine occurrence of the diseases of interest. After completing a validation study, we assembled the Québec Birth Cohort on Immunity and Health (QBCIH, n=81,496) to study the association between BCG vaccination and childhood asthma. We are also studying BCG vaccination in relation to diabetes occurrence. Perinatal information, BCG vaccination and health encounters related to asthma, diabetes, and several allergic diseases were gathered from administrative databases. Additional relevant information, unavailable in these databases, was collected among 1643 participants using a two-stage sampling strategy with a balanced design. Analyses are ongoing for several sub-projects.