Grant: Foundation Grant

Colorectal cancer (CRC) is a leading cause of cancer death and will increase with Canada's aging population. Screening reduces the burden of CRC, however currently screening participation is low. As an established health care researcher, I will lead a program of research over the next 7 years aimed to reduce the public health burden of CRC by improving the quality of screening programs. For the proposed program of research, my objectives are to 1) identify the best direct correspondence strategy to improve CRC screening program participation and 2) compare the effectiveness and cost-effectiveness of two screening tests, Fecal Immunochemical Testing (FIT) and Flexible Sigmoidoscopy (FS). These studies will be embedded in Ontario's ColonCancerCheck program, Canada's first and largest CRC screening program. We have assembled a diverse team with expertise in epidemiology, clinical trials, population-health, and economic evaluation to ensure this research program produces high-quality rigorous research, and because our team of experts includes leaders of the CCC program, and other Canadian screening programs, our results will be translated into changes in screening programs across Canada. Our Research Program will provide an exciting opportunity to train and mentor post-doctoral fellows, graduate and undergraduate students in a unique environment. The support of Cancer Care Ontario through the CCC program, makes this proposal feasible; this is an important opportunity to leverage existing resources. This innovative program of research will produce effective strategies to improve participation in CRC screening through correspondence, and will evaluate the role of 2 important screening methods - our findings will be implemented in Ontario and disseminated nationally and to programs worldwide. With my leadership position at CCO and integration with policy makers, I am confident that this research will impact CRC screening policy and service delivery in Canada.