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 TomorrowProject are “phenomenally powerful,”Friedenreich says, and have helped shapehealthcare policy and prevention strategiesfor decades (see sidebar). But, this type ofstudy also takes time and resources. “Youhave to follow a large number of people sothat you have a large enough sample sizeat the end to be able to look at the differentdisease outcomes,” she says.
Since information is being collectedfrom people years, or decades, before theydevelop cancer or other chronic diseases,researchers are better able to trace whatfactors may be responsible.
In other types of studies, where peoplewith a disease are compared to people whodon’t, the sick may be more likely to try tofind an explanation for their illness.
“They may ruminate more abouttheir exposures, or what they did in thepast that might explain why they havecancer or whatever chronic disease,”says Friedenreich.
Collecting information from people be-
fore ilness removes bias from study results.
For Smith, answering hundreds of questions — everything from the colour of herhair to how often she eats orange vegetables — had the added benefit of forcing herto take stock of her own habits.
“It felt like I was putting myself undera microscope in a couple of ways. First ofall, am I doing enough exercise, am I eatinggood food, am I doing this, am I doingthat?” 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 uponline at in4tomorrow.ca or call 1-877-919-9292.