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Research Interests

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My research interests are in cancer epidemiology, environmental health, health equity and small-areas analyses. I am particularly interested in the development and applications of methods that account for real life complexities (i.e. biological, socio-economic, environmental, lifestyle and modifiable factors) that can influence health risk at varying scales—individuals, communities and populations. Primary cancer prevention is central to my platform of research which focuses on improving health quality and equity and informing the people about their exposure risks and health outcomes. I value interdisciplinary and collaborative research that also enables decision makers to respond effectively to cancer-related community concerns, identify communities with excess risk and; be proactive in crafting relevant risk reduction programs tailored to reduce the cancer burden experienced by each community.

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Research Experience Summary

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Local engagement: Some of my previous work has focused on the risk of dying prematurely as a result of living in a socially and/or materially deprived neighborhood. I have also estimated the risk of developing urinary tract cancer as a result of living in communities where levels of arsenic in well drinking water exceed those recommended by Health Canada. Currently, I am establishing a research platform that employs small-area modeling methods to assess the joint distribution of cancers; how they relate to neighborhood socioeconomic profiles and built environments and; how this knowledge could be used to inform cancer primary prevention strategies. This research will enable decision makers to respond efficiently and effectively to cancer-related community concerns, identify communities with excess risk and; be proactive in crafting relevant risk reduction programs tailored to reduce the cancer burden experienced by each community in Nova Scotia. The knowledge gain will be empowering to communities, especially those with concerns that need to be promptly addressed. The work will inform people about the types of cancers that have impacted their communities over time and help them identify exposure risks to avoid or address for the benefit of their future health. This research collective known as the NS Community Cancer Matrix, has the potential to fill the knowledge gap needed for engaging governments, health authorities, communities and the people into a partnership in which all are accountable to prevent cancer in the most cost-effective and sustainable manner. I am also collaborating on a number of local research activities including one focusing on merging datasets of drinking well-water samples from Can Path and the NS Department of Energy and Mines so as to create exposure risk maps of heavy metal contaminants for Nova Scotia. I have also joined a team to study the association between inflammatory bowel diseases (IBD) and geographic risk factors in Nova Scotia where some of the highest rates of IBD in the world have been reported. This work aligns quite well with my interests in cancer prevention, Crohn’s disease being an important risk factor in the development of colorectal cancer (CRC). In addition, as people living with IBD do not quality for CRC screening, future work will focus on investigating the relationships between community-level prevalence of IBD, screening uptake rates and CRC incidence.

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National engagement: The Cancer Matrix work led locally and transferable nationally as well as the well- water contaminants risk maps, will be foundational for a number of research projects such as those focused on ‘Cancer risks of Arsenic and Radon environmental Exposures’ (CARE) and being currently developed by an interdisciplinary group of researchers members of the Canadian Environmental Exposures in Cancer (CE2C) network and including myself. The mission of CARE research is to decrease the future cancer burden in Canada from arsenic and radon exposures that can lead to urogenital and high-fatality cancers such as lung cancer.

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International engagement: As a Senior Cancer Epidemiologist, I am a local principal investigator on a number of international initiatives including those led by: (1) the International Cancer Benchmarking Partnership (ICBP), a unique and innovative collaboration that brings together clinicians, policymakers, researchers and data experts across the world and; (2) the CONCORD programme. The ICBP aims to measure international variation in cancer survival, incidence and mortality, as well as identify factors that might be driving these differences in high income countries whereas the CONCORD aims to maintain systematic global surveillance of cancer survival, by documenting world-wide trends and inequalities in cancer survival.