Background to ON-DECK - Paul Villeneuve speaks about the large case-control study that ON-DECK is founded on

1. TheNationalEnhancedCancerSurveillanceSystem
PaulVilleneuve
Associate Professor
Department of Health Sciences
Carleton University

2. The NECSS
• Proposal was launched in 1994
• A collaborative effort between Health Canada and the Provincial
Cancer Registries.
• Funded under Government of Canada's Green Plan.
• Four components
1. Geographic surveillance of cancer incidence to identify high
risk clusters and potential determinants
2. National Environmental Quality Database
3. Case-control surveillance infrastructure (population-based)
4. Environment hot issue management

3. The NECSS case-control study
•8 participating registries (BC, Alberta,
Saskatchewan, Manitoba, Ontario, Nova Scotia,
Newfoundland, and Prince Edward Island)
•Attempted to identify cases within 3 months of
diagnosis
•Data were collected between 1994 and 1997
•Data were collected for 19 different cancer sites

4. Incident cases, by type - Female
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2000

5. Incident cases, by type – Male
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6. Controls
• Initial aim was to select ~ 5000 controls
• Age structure to match age distribution of all cancer cases (at
least one control for every case within each sex and 5-year age
group for any specific cancer site).
• Selected using different methods across provinces
• RDD – Newfoundland, and Alberta
• Provincial health data - British Columbia, Saskatchewan,
Manitoba, PEI and Nova Scotia
• Property Assessment File - Ontario
• Overall response rate
• Males: 64%
• Females: 70%

7. Questionnaire
• Self-reported (mailed)
• Comprehensive suite of
risk factors
• Alcohol, smoking, second
hand smoke
• Social determinants of
health
• Lifetime residential and
occupational histories
Anthropometry
(PA / BMI)
Diet
Occupation
SES
Residential

8. Previous work involving NECSS
• Generated a large number of papers (~80)
• Formed basis on thesis projects for at least 20 graduate students
• Used in numerous pooled analyses of case-control studies
• Studies conducted to date have largely focused on lifestyle risk
factors
• Obesity
• Recreational Physical Activity
• Cigarette Smoking, Second Hand Smoke, Alcohol Use
• Diet
• To date, relatively few studies on the environmental and
occupational causes

9. Environmental Causes of Cancer
• Examined role of water quality, and air
pollution
• Proximity to industry (NHL)
• New exposure assessment methods
provide new opportunities
• Extrapolation to past exposures remains a
challenge
• Several recent paper s have been
generated

10. Occupational Questions

11. Occupational Questions (2)

12. Occupational causes of cancer
• Very few studies
• Previous NECSS work has examined:
• EMFs and brain cancer and male breast cancer
• Employment in animal related occupations and NHL, and leukemia
• Bladder cancer and job title analyses
• In 2007, Health Canada supported analyses of occupational analyses
of lung cancer (silica, asbestos, gasoline and diesel emissions)
• Involved coding occupations
• We’ve expanded this work to include other cancer sites including
kidney

13. Future work to consider
Environment and Occupational Exposures
• Occupational physical activity
• Air Pollution and other cancers
• Virtually no examination of associations in women
• Additional work could include
• More detailed analyses of other exposure including
pesticides
• Proximity to specific industries
• Expand some past efforts to other cancer sites
• Development of job exposure matrices

14. Requests to use NECSS
• Subject to data sharing agreement
• Acknowledge authorship of Canadian Cancer
Registries Epidemiology Group
• Further information email me:
Paul.Villeneuve@Carleton.ca
Thank-you!