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The Canadian Partnership for Tomorrow Project: Canada's Platform for Chronic Disease Prevention Research
The Canadian Partnership for Tomorrow Project (CPTP) is a national, long-term study that will follow over 300,000 men and women for up to 50 years. The CPTP aims to investigate environmental, lifestyle and genetic factors related to the development of cancer and other chronic diseases. This cohort study has enrolled Canadians between the ages of 35 and 69 years old from British Columbia, Alberta, Ontario, Quebec and the four Atlantic provinces. Participants have completed a baseline questionnaire and consented to future contact and linkage with administrative databases. Currently over 120,000 participants have also provided a blood and urine sample, and by 2017, samples will be collected from over 180,000 participants. The study has also collected baseline physical measurements on over 85,000 participants. The CPTP is by far the most ambitious and powerful platform ever created in Canada, and has been designed to be able to combine with other cohort studies around the world to answer questions on rare diseases or exposures. It will support novel, leading edge Canadian and international trans-disciplinary chronic disease research long into the future.
Data sources (to be) linked:
- Self-report questionnaires on lifestyle, medical history and other chronic disease risk factors
- Physical measurements, including height, weight, blood pressure and body fat composition
- Genetic determinants of chronic disease from DNA (future)
- Biomarkers of exposure, lifestyle and disease from the biological samples (future)
- Vital Statistics
- Cancer Incidence
- Physician billing records
- Hospital discharge abstracts
- Prescription medications (in BC)
- Environmental data (water, air, neighborhood factors) linked to residential history (future)
- Occupational exposure data linked to job history (future)
Strengths and caveats associated with data use:
Prospective cohorts such as CPTP eliminate many of the weaknesses of other study designs as questionnaires and samples are obtained before the onset of disease. Although these cohorts are costly and may take decades or more before major results are obtained, they provide the gold standard for research into the causation and early detection of chronic diseases. In fact, because many diseases can be studied simultaneously, the cost over time per health outcome studied can be substantially lower than the cost of case–control studies for a comparable number of participants.
Impact to health policy and implications for related research:
- The creation of a “population laboratory” for leading-edge, population-based basic and translational research related to cancer and chronic diseases within Canada.
- A bank of biologic specimens and related personal risk factor data that can be linked with provincial data on disease outcome and health care utilization.
- A resource and legacy for future generations of researchers that will continue to yield valuable information about health and risks of disease.
For policy, prevention and care:
- A platform that enables improvement in the control of cancer and the incidence of chronic disease through identification of new risk factors that may be modified through preventive interventions.
- A platform that enables reduction in disease-related mortality through detection of new prognostic factors and markers of early disease.
- An observatory for tracking the results of “natural experiments” occurring over time related to interprovincial variations in the introduction of new technologies, new programs for preventing disease or methods of health care delivery.
- A mechanism for predicting future needs for care, through the tracking of factors that are likely to predict future incidence of disease and related mortality, and the associated costs.
- A platform for investigating the policy issues associated with population studies.
- A mechanism for monitoring uptake of screening and prevention initiatives by the Canadian population and the impact of these initiatives.
John Spinelli is the Head of Cancer Control Research at the BC Cancer Agency, Professor in the School of Population and Public Health at the University of British Columbia, and Adjunct Professor in the Department of Statistics and Actuarial Science at Simon Fraser University. He is the principal investigator for the BC Generations Project, part of the Canadian Partnership for Tomorrow Project, the largest health study ever undertaken in Canada.