2018 Women’s Health Research Institute Catalyst Grant Recipients

The Women’s Health Research Institute (WHRI) is very pleased to congratulate the recipients of the 2018 Women’s Health Research Institute Catalyst Grants. This competition was funded thanks to the dedicated support of the BC Women’s Hospital + Health Centre Foundation.

This grant competition provides support for pilot studies in women’s and newborn’s health, which aim to generate preliminary data; test new approaches, methodologies or tools; bring new teams together; and/or support new research in women’s and newborn’s health from established researchers.

Recipient of the Auxiliary to BC Women’s Catalyst Grant

Pascal Lavoie, Division of Neonatology, Department of Pediatrics, University of British Columbia

Team: Pascal Lavoie (PI), Suzanne Vercauteren (Co-PI), Jefferson Terry (Co-PI), Soren Gantt (Co-I), Wendy Robinson (Co-I), Alexander Beristain (Co-I), Ruth Grunau (Co-I), Rajavel Elango (Co-I)

Project: BC Women’s Hospital Preemie BioBank

Summary: In Canada, 8% of infants are born premature, before 37 weeks of gestation (40,000 infants per year). These infants suffer increased medical complications at birth with life-long health consequences. Health research is essential to discover new treatments for these problems. Biobanks are crucial to provide researchers with biological materials (e.g. human cells and tissues) to model disease process and the effect of new treatments without imposing a health risk to patients. The purpose of this project is to consolidate the BC Women’s Hospital (BCWH) Preemie Biobank initiative, the first Biobank in Canada dedicated to the collection of biological cord blood and placental tissues for research related to preterm birth and health problems in premature babies. Our main objective is to seek parents’ opinions and involvement into directing the process and priorities of the Biobank. The results of this study will also provide guidance on how to improve the acquisition of high quality biological specimens for innovative research, from the perspective of health providers. In the long-term, we hope that this study will enhance our ability to positively impact the health of premature babies through discovery research.

Recipient of the 2018 WHRI Catalyst Grant

Cindy K. Barha, Postdoctoral Fellow, Department of Physical Therapy, University of British Columbia

Team: Cindy K. Barha (PI), Liisa Galea (Co-I), Teresa Liu-Ambrose (Co-I), Rachel Crockett (Co-I)

Project: Momnesia: Investigating the neural basis for reduced memory and executive functions across pregnancy

Summary: Over 80% of women complain of declines in cognition during pregnancy. The negative impact of these deficits on maternal quality of life is significant. Although not well-studied, objective measurements support the claims of subjective memory declines during pregnancy. Fewer studies have examined executive functions during pregnancy, the capacity to plan, organize, and monitor goal-oriented behaviours; however, evidence does support declines in this as well. Importantly, little is known about the mechanisms underlying these declines in memory and executive functions in humans. Therefore, the aim of the proposed study is to examine the role of activation in the two brain regions that subserve these two cognitive domains, the medial temporal lobe and prefrontal cortex, using functional near-infrared spectroscopy (fNIRS), a cost-effective, non-invasive alternative to neuroimaging that is safe for use during pregnancy. We will also look at how pregnancy-related hormones, sex of the baby, severity of nausea/vomiting during pregnancy, and level of physical activity are involved in these cognitive deficits. We will recruit 15 women pregnant for the first time and 15 age- and education-matched non-pregnant women. All women will be assessed at 3 time points: for pregnant women at 12, 24, and 37 weeks since last menstrual period, and for control women at 3-month intervals. The resulting data will greatly aid in our understanding of how pregnancy affects the brain of women and has the potential to improve the mental health of women in British Columbia and beyond to ensure each child and mother thrives.

Recipient of the 2018 WHRI Catalyst Grant

Laura Schummers, Postdoctoral Fellow, Department of Family Practice, University of British Columbia

Team: Laura Schummers (PI), Wendy Norman (Co-I), Kim McGrail (Co-I), Elizabeth Darling (Co-I), Sheila Dunn (Co-I), Glenys Webster (Principal Knowledge User)

Project: Catalyst to facilitate Access to Mifepristone and Outcomes Study (CAMOS)

Summary:

Background: One in three Canadian women have at least one abortion. Until 2017, 96% of abortions were performed surgically in fewer than 100 (primarily urban) facilities. Access to abortion services was inequitable; including significant urban-rural disparities. The medical abortion drug mifepristone became available in Canada in January 2017. Mifepristone can be provided in primary care and is a safe, effective alternative to surgical abortion. Thus, mifepristone could improve abortion access and reduce inequities considerably. However, the extent to which mifepristone introduction has impacted abortion service access, abortion related adverse events, and health system costs, is not known. Health system leaders have identified an urgent need to understand the implications of this major abortion policy change.

Research Question: What was the distribution of abortion access, abortion-related adverse events, and abortion costs in BC and ON before the introduction of mifepristone medical abortion?

Method: Our research team aims to conduct a population-based cohort study among all patients undergoing abortion in British Columbia and Ontario from January 2012-December 2019 using administrative health data (e.g., billing codes; hospital discharge records; prescriptions). This Catalyst Grant will support crucial pilot work to 1) determine similarities and differences in data sources to ensure cross-province consistency for abortion and outcome measures, and 2) describe abortion usage, abortion access, abortion-related adverse event rates, and abortion service costs in BC and ON before the introduction of mifepristone medical abortion.

Impact: This Catalyst Grant will facilitate the first comprehensive examination of Canadian abortion services following mifepristone introduction and will provide critical information for health system leaders to evaluate recent abortion policy changes.

Member Spotlight: Congratulations to Laura Schummers!

This month our spotlight is on Laura Schummers, a Postdoctoral Fellow working with the Contraception and Abortion Research Team (CART-GRAC)! Laura was recently awarded a Michael Smith Foundation for Health Research (MSFHR) Research Trainee Fellowship for her project “Mifepristone outcomes study: Examining abortion access, outcomes, and costs following the introduction of mifepristone”, as well as a Health Systems Impact Fellowship co-funded by CIHR and the BC Ministry of Health for her work “Population-based epidemiological analysis to evaluate and inform reproductive health policies in British Columbia.”

Laura’s work uses epidemiological and health services research methods to better understand the causes and predictors of reproductive, maternal, and infant pregnancy outcomes. Her doctoral work looked at population-level administrative health data to examine the relationship between maternal age, pregnancy spacing, and adverse pregnancy outcomes. Findings from her study of  adverse pregnancy outcomes and maternal age detail risks for different maternal ages, and suggest that risks for both mother and baby increase gradually with increasing maternal age, rather than abruptly increasing at specific ages (such as age 35 or 40). Her doctoral work recently made waves across the media, suggesting that waiting less than a year between pregnancies increases risk for infants, regardless of maternal age, and increases risks for mothers for those age 35 or older. These findings provide useful tools for clinical counselling and family planning, and can help reassure older women who may also be weighing age-related risks that it is worth spacing pregnancies out 1-2 years.

Her postdoctoral work will look at the extent to which introduction of the medical abortion drug Mifepristone improved abortion access in Canada, as well as any other outcomes of this policy change. Laura will look at administrative health data to see how access was impacted, and whether or not there are new challenges to address, such as patient safety or health systems costs.

The fellowship places Laura in a unique position, as she has is co-located within the BC Ministry of Health in the Public Health Services division, Perinatal Services BC, and BC Women’s Hospital, along with her academic site in Women’s Health Research Institute. This means that the policy organizations responsible for implementing the change are working with her to evaluate their impact, and that she can try to ensure her research findings are easily interpretable for a policy audience.

Congratulations, Laura!

REFERENCES

Laura Schummers, S., Jennifer A. Hutcheon, P., Sonia Hernandez-Diaz, D., & al, e. (2018). Association of Short Interpregnancy Interval With Pregnancy Outcomes According to Maternal Age. JAMA Internal Medicine.

Schummers, L., Hutcheon, J. A., Hacker, M. R., VanderWeele, T. J., Williams, P. L., McElrath, T. F., et al. (2018). Absolute Risks of Obstetric Outcomes Risks by Maternal Age at First Birth: A Population-based Cohort. Epidemiology, 379-387.

Dr. Jerilynn Prior: The ABCs of Osteoporosis

Osteoporosis, a disease which deteriorates bone tissue and increases the risk for fractures, affects approximately 2 million Canadians (Osteoporosis Canada). November is Osteoporosis Awareness month, a time to raise awareness and discuss prevention – but often popular conversation doesn’t include young women and the steps they can take to decrease their risk.

Dr. Jerilynn C Prior is an endocrinologist who authored the ABCs of Osteoporosis Prevention for Teenaged Women to help bridge this gap and raise awareness among healthcare providers, young women, and their caregivers about the unique steps they can take for better life-long bone health.


The original ABCs of Osteoporosis Prevention came about when Dr. Prior was invited to speak with Bill Good on CKNW. She describes her rainy walk to the station and how she began trying to put her advice into an easy-to-follow alphabetical format.

For teenaged women, the ABCs begin with ‘A’ for Active, followed by ‘B’ for Brawny.

“Brawny fits because you need normal muscle for bone to be normal, and it’s also an opportunity to talk about keeping a steady, normal weight. If you have to lose weight, lose it very slowly – otherwise you will lose bone.”

Next are ‘C’ for Calcium, ‘D’ for Vitamin D and ‘E’ for Easygoing which Dr. Prior emphasizes as a very important step.

“I think I was one of the first people to identify that those…who we were seeing with osteoporosis were high-strung, or on-edge, or anxious, or insecure – you can use all kinds of different terms,” she says. “There are connections we now know of between the sympathetic nervous system and links between depression and bone loss. Anything that raises cortisol affects your bones.”

Similarly important is ‘F’ for bone formation, because most medications and supplements “work to prevent bone loss, but don’t work to increase new bone,” she explains. And, like calcium and vitamin D, hormones are also a critical component for bone formation.

“Basically, for adolescent men it’s important that their testosterone rises into normal male range. For women, it’s important they get their cycles at the normal time each month and develop normal ovulation and progesterone,” she says. “When it comes to the ‘F’ – formation and fertility – one instruction for adolescents is to avoid the birth control pill if at all possible.”

Population-based Canada-wide data from the Canadian Multicentre Osteoporosis Study (CaMos) in adolescent women found that the “use of combined hormonal contraception before age 19 or 20 appears to interfere with gaining toward peak bone mass in the hip region. Furthermore a meta-analysis of studies of spinal bone change by use of combined hormonal contraception or not shows that those using the Pill are significantly losing bone although this data is so far only published as an abstract.”

“I now have pretty strong data about the role of progesterone in bone formation, [although] it is still controversial. It has taken me twenty five years of gathering and interpreting [data] and doing studies that would show it. These data were recently published in an open-access Climacteric review.”

Finally, ‘G’ and ‘H’ are combined for Good Habits. That is, regular sleep, avoiding excessive alcohol and any tobacco, and, importantly, having a good diet. Data derived through principle components analysis of diet variables among those who completed a food-frequency questionnaire in the CaMos  cohort found that menopausal women who were predominantly on a nutrient-dense diet had fewer new fractures over time than menopausal women on a more calorie-dense or Western-type diet.

The ABCs of Osteoporosis Prevention have been adapted by Dr. Prior for premenopausal women, menopausal women with osteoporosis, midlife women, healthy menopausal women, men who have prostate cancer who are on androgen-ablation therapy, and now, adolescent women. With a CIHR grant the adolescent and premenopausal ABCs are being disseminated through both English and French animated videos. The print materials for all of these are available through the CeMCOR website. Additionally, Dr. Prior is engaging with both the public and healthcare professionals to bring this important information to light through workshops and public talks.

In future, Dr. Prior hopes to adapt the ABCs for adolescent and older men, too.

Watch the ABCs of Osteoporosis Prevention for Teenaged Women here.

Watch the ABCs of Osteoporosis Prevention for Premenopausal Women here.


Jerilynn C. Prior BA, MD, FRCPC is a Professor of Endocrinology and Metabolism at the University of British Columbia working on women’s health. She studies menstrual cycles and the effects of ovulation and its disturbances on women’s later life osteoporotic fracture, heart attack and breast cancer risks. She is British Columbia Centre Director of the Canadian Multicentre Osteoporosis Study (CaMos, www.camos.org), a 20-year prospective 9-centre population-based bone and general health study; she is also the Scientific Director and Founder of the Centre for Menstrual Cycle and Ovulation Research (www.cemcor.ca ).

References
J. C. Prior. (2018) Progesterone for treatment of symptomatic menopausal women. Climacteric 21:4, pages 358-365.

Research spotlight: CervixCheck

Cervical cancer screening using the pap test remains critical for this preventable disease. In BC, provincial screening rates have remained the same over the last decade where approximately 30% of the population are under or never screened. Despite this, few interventions have been implemented to increase screening, where rates are lowest among priority populations who face barriers to clinic-based screening.

CervixCheck is a website developed by the BC Centre for Disease Control (BCCDC) and the BC Cancer Cervix Screening Program. Using CervixCheck, women who are overdue for cervical cancer screening can order a kit to perform cervical cancer screening at home. This is a pilot research project where women will be recruited from collaborating family medical clinics in Surrey, an urban centre with some of the lowest regional screening rates in the province and large South Asian population.

CervixCheck was modelled off of the successful BCCDC “virtual clinic” for sexually transmitted and blood-borne infections (STBBI) called GetCheckedOnline.com (GCO), using existing code-base, infrastructure and safeguards. Evaluations of GCO have demonstrated:

  • high diagnosis rates;
  • high satisfaction because of the privacy and convenience of the online service;
  • users reported barriers to accessing testing prior to the service, compared to clinic clients;
  • despite common assumptions GCO users were not more likely to be youth or have higher digital literacy;
  • the service reached previously untested individuals.

Online services for self-collection at home, and clinician-collected screening for HPV testing are available commercially in Canada, however CervixCheck will be the first service of its kind administered in the publicly funded health system. To verify our assumptions in the development stages of the project, we administered a digital health survey to assess South Asian womens’ willingness to use the service and digital literacy. Women were recruited from the family practice clinics where CervixCheck will be piloted, and included 51 women between 30-65 years. Among the findings from this survey we found that

  • 30% of women reported being under/never-screened
  • Over 86% of women self-rated their general Internet skills as average or better
  • 80% of women responded somewhat likely to very likely to participate in CervixCheck
  • 70% of women responded somewhat likely to very likely to collecting their own vaginal specimen
  • Over 90% of women feel comfortable reading and understanding English

CervixCheck is planning to launch in January 2019 and will be available in English for the pilot, however the print and instructional materials associated with the screening project will also be offered in Punjabi. The lessons from this pilot project will be used to inform possible implementation within the BC Cervix Screening Program, as well as other under-screened populations, particularly in Northern BC where our team had engaged stakeholders and secured funding for an additional pilot.

Member Spotlight: Dr. Paula Gordon

Last month Minister of Health Adrian Dix announced that BC would become the first province to share breast density results with all women and their healthcare providers with their mammography screening. Dr. Paula Gordon, Medical Director of the Sadie Diamond Breast Program at BC Women’s Hospital, along with the organization Dense Breasts Canada, was instrumental in advocating for this policy change.

In honour of Breast Cancer Awareness month, we spoke to Dr. Gordon about this change and its impact on women throughout the province.

 

  1. What was your involvement in the push toward communicating breast density results in BC?

I’m a volunteer advisor to Dense Breasts Canada, a non-profit group of breast cancer survivors and medical professionals striving to educate women and physicians about the risks associated with having dense breasts.

  1. How is breast density related to breast health?

It’s normal and common to have dense breasts. But having dense breast tissue puts a woman at increased risk for getting breast cancer. Having the highest category of breast density is a greater risk factor than having a mother or sister with breast cancer. And when a woman’s breast tissue is dense, it makes it harder to see a cancer on a mammogram. Cancers and normal dense tissue both appear white on a mammogram, so looking for a cancer “is like looking for a snow ball in a snowstorm.” Women with fatty breasts are at lower risk AND it’s easier to see cancer in a fatty breast.

  1. Why is it important that women are informed about their breast density?

Mammograms miss 50% of cancers in women with dense tissue. So, women with dense breasts need to know that they can’t have the same trust in the accuracy of their mammogram, than women can if they have fatty breasts. They should still have mammograms, but should also do breast self-examination, and should discuss the option of additional screening with ultrasound, with their family doctor. BC Cancer will initiate a program to educate physicians about dense breasts in 2019.

  1. How will this decision impact women in BC?

Hopefully, women who learn that they have dense breasts will be in a position to make informed decisions about their health. ALL women would ideally improve their lifestyle to reduce their risk of getting breast cancer.

Changes include:

  • Maintaining a healthy body weight, especially after menopause
  • Doing regular, moderately-intense exercise
  • Reducing the use of hormone therapy after menopause (use the lowest possible dose for the shortest possible time, avoiding oral estrogen, and balancing the risks with the benefits to their quality of life
  • Minimizing their alcohol consumption: there’s a linear relationship between alcohol use and breast cancer risk. So enjoy, but in moderation
  • Have routine screening mammography.

Women with dense breasts should discuss the option for supplemental screening with their family physician. Currently, there is evidence to show that ultrasound finds an additional 3-4 cancers per thousand women. But like any screening test (like mammograms and pap smears) ultrasound can create false alarms, which can necessitate additional testing to determine whether cancer is present, or not. But when ultrasound finds these cancers, they are usually small, and not yet spread to lymph nodes. So these women are good candidates for less aggressive surgery and often do not require chemotherapy. When not found early, women are more likely to need mastectomies and chemotherapy.


Read more about the announcement here.

Research Spotlight: The TMIST Trial

The Tomosynthesis Mammographic Imaging Screening Trial (TMIST) is a randomized, breast cancer screening trial that will help researchers learn about the best ways to find breast cancer in women who have no symptoms.

It compares two approved types of digital mammography: standard digital mammography (2-D) with a newer technology called tomosynthesis mammography (3-D). 2-D mammography takes pictures from two angles of the breast to create a flat image. 3-D mammography images are taken from multiple angles around the breast and then reconstructed into a 3-D-like image.

The goal of breast cancer screening is to find breast cancer early when it may be easier to treat. The TMIST trial aims to find out whether the newer technology is more effective than conventional 2-D mammography at reducing life-threatening (advanced) breast cancers.

The TMIST Lead-In study, led by Dr. Paula Gordon at the Breast Health Centre at C&W and Dr. Linda Warren at X-Ray 505, is now in its follow up stages with one-third of the 306 study participants completing their final screen to date. This Lead-In study has been funded by The Diamond Family.

Another important aspect of the trial is to build a tissue bank for future research. All women who joined the trial have been asked to submit tissue samples, such as blood and cheek swabs.  Researchers hope that the information from these tissue samples will help decide the best ways to screen for breast cancer in the future by taking a person’s genetics and other personal risk factors into account. Currently we have collected bio-specimens from approximately 25% of the participants.

With the success of the Lead-In study, we are nearly ready to begin recruitment on the main TMIST study. Women ages 45 to 74 who are planning to get a routine screening mammogram are eligible for this trial. The main study will be funded by the NIH.

If you would like to participate, or would like further information on participating, please contact the research team at TMIST@cw.bc.ca

World Heart Day 2018: An Interview with Dr. Karen Tran

September 29th is World Heart Day. Check out our Q&A with Dr. Karen Tran on her research on hypertensive disorders in pregnant women!

  1. What are hypertensive disorders? Do they affect pregnant women differently than non-pregnant women?

High blood pressure affects 1 in 4 Canadians and is the most common reason for Canadians to see their family doctors. Untreated high blood pressure is a major risk factor for heart attacks, strokes, heart failure, and kidney disease. Despite women being more likely than men to be treated for their high blood pressure, women are less likely to achieve blood pressure control.

In contrast, high blood pressure in pregnancy occurs in 5-10% of pregnant women, and accounts for a majority of maternal, fetal and neonatal morbidity and mortality. In BC alone, 1800 deliveries annually are complicated by hypertension and preeclampsia. Also, we know that pregnant women who having high blood pressure in their pregnancy are at increased risk of developing hypertension, cardiovascular disease, such as heart disease and stroke in the future.

2. In 2-3 sentences, could you briefly describe your research?

Together with Dr. Wee Shian Chan, we are interested in understanding how measuring blood pressure at home can improve how we care for pregnant women who develop hypertension during their pregnancies. We know that home blood pressure monitoring is more reliable than office blood pressure and associated with better outcomes in non-pregnant women, but we do not know if the same is true in pregnant women.

  1. What are some of the differences between how blood pressure is measured between pregnant women and non-pregnant women? Why are these processes different?

In non-pregnant women, home blood pressure monitoring leads to improved cardiovascular outcomes, adherence to medications, overall lower blood pressure, and increased patient satisfaction. There are also good recommendations on how often to measure blood pressure at home, as well as home blood pressure targets to achieve. This unfortunately is not the case for pregnant women. Currently, the diagnosis and management of high blood pressure in pregnant women rely on blood pressure measured in a doctor’s office, which can be inaccurate.

  1. How do these knowledge gaps currently impact pregnant women?

Even though, many doctors recommend that pregnant women measure their blood pressure at home, we are still not clear how often they should be doing this, what blood pressure they should achieve, how to use these blood pressure measurements to manage their care and whether or not this would reduce complications to mothers and their newborn babies.

  1. Why is this research important? How might it change clinical practice?

By measuring blood pressure at home, we hope to engage and empower women to take an active role in their health.  Many pregnant women already measure their blood pressure at home, but we require evidence to guide doctors on which home blood pressure thresholds to diagnose high blood pressure and what their home blood pressure targets should be to manage hypertension in pregnancy. Furthermore, we need to make sure that home blood pressures are measured accurately using validated blood pressure machines. In the future, we hope that clinicians will be able to rely on home blood pressure measurements to manage hypertension in pregnant women and improve the health of mothers and their new babies.

Maternal Microbiome Legacy Project Update

The Maternal Microbiome LEGACY Project team is excited to announce the launch of our second study site, being led by Dr. Sheona Mitchell-Foster at the University Hospital of Northern BC (UHNBC) in Prince George!

The goal of the Maternal Microbiome LEGACY Project, being led by Dr. Deborah Money, is to help clarify the link between the vaginal microbiome, mode of the delivery (vaginal or caesarean section delivery), and the development of the infant gut microbiome. Since its launch earlier this year at BC Women’s Hospital, the Maternal Microbiome LEGACY Project has recruited over 160 participants from the greater Vancouver area. The addition of our Prince George site will help in establishing a study population which is more representative of the British Columbia population.

This is a longitudinal study of women with term deliveries, with women and their infants being followed for 3 months after delivery. We are looking to recruit 920 women over the course of the study. To participate, women should be pregnant with a single or twin pregnancy, over 19 years of age, and be registered for hospital or home delivery at one of our study sites.

We thank the women who have participated so far and expressed interest in our study, and all of the nursing and clinical staff who have facilitated with in-hospital sample collection!

For more information, visit the study website, or follow MaternalLegacy on Facebook and Twitter.

If you would like to participate, or would like further information on participating, please fill out this survey.

For general study inquiries, please email the Study Manager, Zahra Pakzad at zahra.pakzad@cw.bc.ca.

Congratulations to Drs. Gina Ogilvie and Marette Lee, recipients of a MSFHR 2018 Implementation Science Team Project Grant!

Dr. Gina Ogilvie and Dr. Marette Lee have received the grant for the “At-Home Cervical Cancer Screening & Strategies To Enhance Engagement With The Care Pathway For Under-Screened Populations project”.

In this proposal we will use implementation science methodology to explore and address barriers to cervical cancer screening in BC to improve access to screening in under-served populations. Over the last decade in BC screening rates have remained at about 70%, which means there is a large proportion of the population who are under or never screened. Despite this, there are few interventions that have been successfully implemented to improve screening rates in priority populations.

Specifically we will use different implementation approaches for self-collected sampling for HPV (human papillomavirus) testing. This is a highly effective, validated tool for cervical screening that can be used to address many of the barriers women face to clinic-based pap testing, which is the current standard in BC. For example, embarrassment or discomfort with a pelvic exam, cultural taboos, or past trauma are reasons some women avoid screening, as well as inconvenient clinic hours, not having a family physician, or time and distance to travel for services. We anticipate that the use of self-screening can address many of these barriers. With this approach, women can collect their own sample in a simple and painless way, and it can be done in the privacy of women’s homes or wherever they are comfortable using it. 

To implement self-screening we are piloting two approaches, one being an online service called CervixCheck where women can order self-sampling kits for screening which are mailed to their home. After they have collected their sample the kit is mailed to the BC Public Health Laboratory for testing, and screening results become viewable online through their personal online account. In the second approach, self-collection based screening will be offered through community health centers.

Initially the program is being piloted in the urban clinics in Surrey with South Asian women, and in Northern BC with rural Indigenous communities. These populations are known to have some of the lowest screening rates in the province and face barriers to traditional screening approaches. This will also allow us to see how our interventions can be adapted to different contexts.

The program is embedded within the provincial health authority at BC Cancer, and will be examining health systems impact and cost-effectiveness to be used for future scale up planning of the program. The team is led by Dr Gina Ogilvie, Associate Director of the WHRI, UBC Professor, and Canada Research Chair in global control of HPV related diseases and cancer; Dr Marette Lee, Provincial Colposcopy Lead for the BC Cancer Cervix Screening Program; Dr Dirk van Niekerk, Medical Director of the BC Cancer Cervix Screening Program; along with an interdisciplinary team of researchers and research users in the Vancouver, Fraser, and Northern Regions of BC. Through health systems implementation research, our goal is that self-collection based screening and CervixCheck can be adopted within the BC Cancer Cervix Screening Program in the future, and serve as a model for other public health programs in BC.

Research spotlight: OVCARE

This Ovarian Cancer Awareness month we are recognizing the history of OVCARE and the strides they’ve made in the field of ovarian cancer research, impacting women’s health around the globe.

In December 2000 in the cafeteria at Vancouver General Hospital (VGH), Drs. David Huntsman, Dianne Miller, and Blake Gilks sat down to brainstorm how they might improve outcomes for women with ovarian cancer. 

Despite conventional research efforts in the field of ovarian cancer – both locally and internationally – there had not yet been a research breakthrough leading to significantly improved outcomes for women with the diagnosis. Most of these women died within five years of receiving the diagnosis, which motivated them to build a multidisciplinary team and core resources to facilitate research. At the time, it was unprecedented to have contrasting perspectives of a pathologist, geneticist, and clinically focused gynaecologic oncologist to tackle this disease.

They presented their plans to the BC Cancer Foundation and the VGH and UBC Hospital Foundation. From there, OVCARE was born.


Today this partnership has made OVCARE a global leader in ovarian cancer research. Their findings have had a profound impact not only in British Columbia, but throughout Canada and the world. Their achievements include discovering that ovarian cancer is not a single disease, but is made up of a number of subtypes of ovarian cancer; discovering driver mutations in several rare ovarian and uterine cancers which are now the diagnostic markers for these cancers; developing a prevention protocol adopted in numerous countries; and  leading Vancouver Coastal Health to become the first region in the world to offer patients presenting with ovarian cancer molecular risk assessment for the two common hereditary cancer syndromes.

Among their successes, their ovarian cancer educational campaign has had a huge impact on women’s health around the globe. The campaign was comprised of three key recommendations: 1) To remove the Fallopian tubes at the time of hysterectomy (opportunistic salpingectomy, a term coined by Dr. Dianne Miller); 2) For women who are undergoing tubal ligation for permanent contraception to undergo opportunistic salpingectomy; and 3) For any woman diagnosed with ovarian cancer to be tested for the BRCA mutations, and for her family members to be tested as well so they have the opportunity to undergo preventative surgery.

With these recommended changes in practice OVCARE predicts they can prevent ovarian cancer in up to 40% of cases. Dr. Gillian Hanley is currently using a population-based database in British Columbia to track the incidence of the disease, as well as to see how many women have undergone opportunistic salpingectomy based off of the recommendations. Preliminary findings show that the uptake of recommendations in 2014 rose 80% in British Columbia, which is the highest rate of growth in the country. While it is currently too early to tell if the incidence of ovarian cancer has been reduced, they anticipate that they may have enough data to analyze toward the end of 2019.

OVCARE encourages other researchers in fields outside of ovarian cancer research to take an interest in studying the disease by developing partnerships which provide access to their resources.  Since the start of OVCARE, the team has expanded and now has an active research program on endometrial cancer led by Drs. Jessica McAlpine and Aline Talhouk.

To learn more about OVCARE visit their site.

Further reading: