from across the country. “It’s the first time
in Canada, we’ve had a large cohort that is
this geographically representative.”
That’s important because Canadians
are exposed to different factors than other
nationalities, and researchers will be able
to look at environmental exposures and
genetic associations that may have not
been considered elsewhere in the world.
Large studies such as the Tomorrow
Project are “phenomenally powerful,”
Friedenreich says, and have helped shape
healthcare policy and prevention strategies
for decades (see sidebar). But, this type of
study also takes time and resources. “You
have to follow a large number of people so
that you have a large enough sample size
at the end to be able to look at the different
disease outcomes,” she says.
Since information is being collected
from people years, or decades, before they
develop cancer or other chronic diseases,
researchers are better able to trace what
factors may be responsible.
In other types of studies, where people
with a disease are compared to people who
don’t, the sick may be more likely to try to
find an explanation for their illness.
“They may ruminate more about
their exposures, or what they did in the
past that might explain why they have
cancer or whatever chronic disease,”
Collecting information from people be-
fore ilness removes bias from study results.
For Smith, answering hundreds of questions — everything from the colour of her
hair to how often she eats orange vegetables — had the added benefit of forcing her
to take stock of her own habits.
“It felt like I was putting myself under
a microscope in a couple of ways. First of
all, am I doing enough exercise, am I eating
good food, am I doing this, am I doing
that?” she says.
“But also, why not me? My friend
had just passed and I was thinking, why
her and not me? What’s the difference
Friedenreich says researchers may be
able to start addressing these and other
questions fairly soon. While the study will
continue for up to five decades, because
so many people are being studied, results
could start pouring in within a few years.
“There might be some cross-sectional
analyses that we can do right away,”
says Friedenreich. “I would say, within
a 10-year period, we will have a large
enough sample size for cancer outcomes
to do lots of different interesting studies,
and for cardiovascular outcomes and
other major chronic diseases, it will
probably be even less time than that.”
The Alberta portion of the study has
a 10-year head start on the national one:
the Tomorrow Project started here a
decade ago and only recently expanded
to include other parts of the country.
“We are really the pioneers here in
Alberta, because we started the cohort
study in 2000 and have led the way for
the rest of Canada in figuring out a lot
of the methods of how we should do the
study and the data collection and the
sampling,” says Friedenreich.
Jason Shenher was one of the 30,000
people in the original Alberta study,
and he was happy to let his information
be used in the bigger, national study.
“Obviously, it’s important because
cancer is a very significant deal. It
affects pretty much everybody, either
them specifically or someone they
know,” says Shenher, 40.
He says, unlike people who sign up for
drug trials or treatment studies hop-
ing the results will deliver immediate
benefits, he knows the Tomorrow Project
won’t reap any quick payback for him.
“It doesn’t really have a lot of specific
benefits for myself,” he says, “but it may
help my kids.” a
*if you are bet ween 35 and 69 years old, have never had cancer and are interested in enrolling in the tomorrow project, sign up
online at in4tomorrow.ca or call 1-877-919-9292.