Southeastern Ontario Research Articles

Integration of multi-disciplinary geospatial data for delineating agroecosystem uniform management zones.

Understanding agricultural ecosystems and their complex interactions with the environment is important for improving agricultural sustainability and environmental protection. Developing the necessary understanding requires approaches that integrate multi-source geospatial data and interdisciplinary relationships at different spatial scales. In order to identify and delineate landscape units representing relatively homogenous biophysical properties and eco-environmental functions at different spatial scales, a hierarchical system of uniform management zones (UMZ) is proposed. The UMZ hierarchy consists of seven levels of units at different spatial scales, namely site-specific, field, local, regional, country, continent, and globe. Relatively few studies have focused on the identification of the two middle levels of units in the hierarchy, namely the local UMZ (LUMZ) and the regional UMZ (RUMZ), which prevents true eco-environmental studies from being carried out across the full range of scales. This study presents a methodology to delineate LUMZ and RUMZ spatial units using land cover, soil, and remote sensing data. A set of objective criteria were defined and applied to evaluate the within-zone homogeneity and between-zone separation of the delineated zones. The approach was applied in a farming and forestry region in southeastern Ontario, Canada, and the methodology was shown to be objective, flexible, and applicable with commonly available spatial data. The hierarchical delineation of UMZs can be used as a tool to organize the spatial structure of agricultural landscapes, to understand spatial relationships between cropping practices and natural resources, and to target areas for application of specific environmental process models and place-based policy interventions.

Coupling thermodynamic modeling and high-resolution in situ LA-ICP-MS monazite geochronology: evidence for Barrovian metamorphism late in the Grenvillian history of southeastern Ontario

Coupling thermodynamic modeling and high-resolution in situ LA-ICP-MS monazite geochronology: evidence for Barrovian metamorphism late in the Grenvillian history of southeastern Ontario

Bacteriological testing of private well water: a trends and guidelines assessment using five years of submissions data from southeastern Ontario.

Rural populations are at an elevated risk of gastrointestinal illness, as they are dependent on private groundwater sources, and water quality remains the responsibility of the owner. Previous research suggests that only a minority of well water owners test their wells for bacteriological contamination. The aim of this study was to use testing records, in conjunction with current provincial guidelines, to assess submission rates and temporal trends in southeastern Ontario. Using five years of data (2008-2012) from the Public Health Ontario Laboratory in Kingston, Ontario, submissions of well water samples from unique properties (identified through geocoding) were descriptively analyzed. Temporal trends in guideline compliance were tested using a Cochran Armitage test. Finally, correlations between time and submission numbers were investigated using a 10-year provincial dataset to identify long-term temporal trends. There were 107,547 submissions in the five years studied, 84% of which were geocoded, culminating in 30,687 unique properties. Although 11%-12% of owners met the guidelines in any given year, only 0.3% met them every year in the five-year study. Statistically significant decreases were found temporally both in the number of properties that met current guidelines and in all samples tested. This study is the first to use submission records, rather than surveys, to definitively demonstrate that private well water submission guidelines are not being met in Ontario. However, there are no consistent guidelines across the country or continent, and limited supporting scientific literature is available. Significant research is required to develop evidence-based policies.

Quantifying brood predation in Largemouth Bass (Micropterus salmoides) associated with catch-and-release angling of nesting males

Largemouth Bass (Micropterus salmoides) is a highly popular and widely exploited sport fish that provides paternal care to its offspring during the reproductive season each spring. During a catch-and-release angling event, brood predators (e.g. genera Lepomis and Ambloplites) can enter Largemouth Bass nests and consume embryos, reducing the parental male’s reproductive success. While the negative impacts of angling nesting bass have been well documented, factors affecting the rate at which embryos are consumed by nest predators have not been studied at either the individual or population scale. We conducted field observations in nine lakes in southeastern Ontario and southwestern Quebec with abundant Largemouth Bass populations and varying brood predator densities to assess what factors affect how quickly brood predation begins once the male is removed, how quickly a male returns to his nest after release, and which males abandon their nests. Brood predator densities varied among lakes, and when predation occurred (65 % of all nests), it began sooner after the male was angled in nests with higher densities of brood predators nearby. The mean return time of a male was 30.0 min after being held in a live well for 15 min. The mean consumption rate (on a per-predator basis) for all nests that experienced predation was 20.9 free swimming fry predator−1 min−1, and the rate was higher in nests with higher mating success. The number of free swimming fry consumed was positively correlated with brood predator densities near the nest prior to angling, and the change in brood size was predictive of whether the male abandoned its nest. Predator density, parental male quality, and mating success were not associated with differences in abandonment decisions.

Expanding the transmission/diffusion dichotomy: Evidence from Canada

We present analyses of linguistic features undergoing change in South Eastern Ontario, Canada: stative possession, deontic modality, intensifiers, and quotatives. The largest urban center of the country (Toronto) and three towns outside the city are analyzed from the comparative sociolinguistic perspective. Parallel frequency and constraints are found in changes with a time depth of 200 years or more, corroborating the parallel transmission of complex systems over time and space. However, changes that began more recently show marked differences across communities. While the youngest generations in the small towns have appropriated the incoming forms, the accompanying suite of functional constraints found in the urban center is absent. This confirms that diffusing changes do not perfectly replicate the model system. There is, however, notable divergence within patterns of diffusion. The expanding changes exhibit varying configurations, depending on the community, its founders, and the stage of development of the change. The results suggest that increasingly complex contact situations will continue to expand the possible outcomes of diffusion.

The Diagnosis and Initial Management of Injury to Lisfranc’s Joints in the Primary Care Setting in South-Eastern Ontario : How are we Doing?

Objectives: Subtle Injuries to the Lisfranc's joint complex (or LFIs) can be difficult to diagnose on initial presentation to the primary care physician (or PCP). Significant research has gone into subspecialty imaging and operative management of LFIs. Little research, unfortunately, has gone into how PCPs, who are typically must initially suspect, and ultimately diagnose LFIs initially, perform when seeing cases typical of LFIs. Methods: A survey that assessed the diagnostic accuracy and management of LFIs in PCPs in Ontario was designed and validated. A final survey was circulated, via mail, to PCPs in southeastern Ontario. 189 of the 851 (22.2%) contacted PCPs responded to the survey. Demographic data was collected and compared to available information to ensure a representative sample. Results: With reference to subtle LFIs, A misdiagnosis of soft tissue sprain was made 35% of the time, while only 17% of respondents were able to correctly identify the unstable nature of the injury. 54% of responding PCPs indicated follow-up with an orthopaedic surgeon within the recommended two weeks. Conclusions: A directed educational intervention aimed at teaching PCPs in Ontario the principles for diagnosis and management of LFIs is indicated. These interventions may potentially help in increasing understanding and increasing the level of clinical suspicion when presented with the clinical scenario that can be associated with LFIs.

Microbial source tracking and spatial analysis of E. coli contaminated private well waters in southeastern Ontario.

Private water supplies, which are the primary source of drinking water for rural communities in developed countries, are at risk of becoming fecally contaminated. It is important to identify the source of contamination in order to better understand and address this human health risk. Microbial source tracking methods using human, bovine and general Bacteroidales markers were performed on 716 well water samples from southeastern Ontario, which had previously tested positive for Escherichia coli. The results were then geospatially analyzed in order to elucidate contamination patterns. Markers for human feces were found in nearly half (49%) of all samples tested, and a statistically significant spatial cluster was observed. A quarter of the samples tested positive for only general Bacteroidales markers (25.7%) and relatively few bovine specific marker positives (12.6%) were found. These findings are fundamental to the understanding of pathogen dynamics and risk in the context of drinking well water and will inform future research regarding host-specific pathogens in private well water samples.

Abstract P6-06-56: Emergency room visits and hospital admission rates after curative chemotherapy for breast cancer. A retrospective single center experience

Abstract Purpose:Patients undergoing curative (adjuvant or neoadjuvant) chemotherapy (CT) for breast cancer in the Southeast Ontario Local Heath Integration Network (LHIN) have higher rates of emergency room (ER) visits and hospital admissions (HA) compared to other LHINs in Ontario, Canada. This study is to determine factors associated with ER visits and HA after curative chemotherapy for breast cancer in a tertiary Ontario hospital. Methods:A retrospective study was conducted of all patients who completed at least one cycle of curative CT for breast cancer at the Cancer Centre for Southeastern Ontario (CCSEO) in 2011 and 2012. We recorded all ER visits and/or HA within 30 days of any cycle of CT. Data collected included demographics, co-morbidities, type and date of surgery, pathologic tumour characteristics (stage, grade and receptor status), type of CT (adjuvant or neoadjuvant) and number of cycles, use and type of granulocyte-colony stimulating factors (G-CSF). We recorded dates and reasons for ER visits, referring patterns to the ER, date of admission and length of stay. Chi-square and t-tests were calculated to determine factors associated with ER visits and HA. Results:149 patients received curative CT at the CCSEO in 2011 and 2012. Mean age was 58 (range 31-88). 97.3% of patients were female. Comorbidities included hypertension (28.4%), diabetes (10.1%), dyslipidemia (10.1%), coronary artery disease (4.7%) and COPD (2%). Stage distribution was: 4.3% stage 1, 48.6% stage 2 and 36.4% stage 3. 60.8% of patients had grade 3 tumors. 69.8% were ER positive and 61.1% were PR positive. 26.2% were Her2 positive. 62.4% had breast conserving surgery and 56.4% had sentinel lymph node biopsy. Most patients received adjuvant CT (85.2%). The most common CT regimen was FEC-D (89.9%), followed by TC (5.4%) and CMF (4%). 88.6% of patients received G-CSF (either Neupogen or Neulasta) at some point during CT. 53% (n = 79) of patients were seen in the ER at least once within 30 days of CT while 13.4% (n = 20) were admitted to hospital. 36.7% (n = 29) had multiple ER visits. There were a total of 133 ER visits. The most common causes of ER visits were fever without neutropenia (23.3%), pain (13.5%) and febrile neutropenia (9%). Most ER visits occurred on weekdays (74%). We analyzed the following factors associated with ER visits and HA rates: age, gender, comorbidities, TNM staging, grade, receptor status, type of surgery and CT (adjuvant versus neoadjuvant). The only statistically significant factor associated with a higher likelihood of ER visits was stage IIIC breast cancer (p = 0.045). Statistically significant factors associated with HA were tumor size with T2 more likely to be admitted (p = 0.019), adjuvant CT (p = 0.045) and number of CT cycles (p = 0.017). Conclusions:Over half of all patients receiving curative CT for breast cancer at the CCSEO in 2011 and 2012 visited the ER at least once and more than 1/3 required multiple visits. The only factor associated with ER visits included stage of disease. Factors associated with HA were tumour size, adjuvant CT and number of CT cycles. While most patients received G-CSF at some point during their CT, febrile neutropenia was still the third most common reason for ER visits. Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P6-06-56.

Analysis of passive-sampler monitored atmospheric ammonia at 74 sites across southern Ontario, Canada

Abstract. Weekly/biweekly concentrations of atmospheric NH3 were collected using passive samplers at 74 sites across southern Ontario, Canada, during the period from June 2006 to March 2007 with eighteen sites running as early as March 2006. The annual average of NH3 (AAN) at all the sites across southwestern Ontario was over 1 μg m−3, a value that was recently proposed as the new critical level for protecting vegetation. High AAN values (3.6–6.1 μg m−3) were observed at eight sites located inside the intensive livestock production zones. AAN values at the sites across southeastern Ontario were generally lower than 1 μg m−3 and the values were less than 0.4 μg m−3 at non-agricultural sites. Agricultural sites generally showed the highest concentrations in spring to summer and the lowest in winter, but the occurrence time of the peak concentration varied among the sites, which could be due to their different land use and thus different fertilizer application intensities or periods. Seasonal trends of NH3 concentration at some non-agricultural sites were somewhat similar to those at the agricultural sites, but the peak concentration appeared a few weeks later than at the agricultural sites. Surprisingly, at several remote non-agricultural sites, NH3 concentrations were not decreasing in winter and were sometimes increasing to a level higher than those in summer, which could be caused by different transport mechanisms in different seasons. A sharp increase in NH3 concentration was also surprisingly observed at 20 out of the 74 sites during the coldest two weeks when ambient temperature was lower than −7 °C, and cannot be explained by known sources or with existing knowledge. The NH3 emission inventory for the region of southern Ontario was evaluated using the measurement data and emissions within two small zones in this region were identified to be potentially underestimated.

Estimating the impacts of browsers on forest understories using a modified index of community composition

Increases in deer densities throughout temperate regions are negatively affecting forest conservation, but approaches for estimating these impacts are labour intensive and thus prohibitive for many managers. Plant indicators provide a rapid and cost-effective approach for measuring the impacts of disturbances on forest communities, and may inform managers both about the need for conservation actions to mitigate deer disturbance and their outcomes. The Floristic Quality Index (FQI) is one metric that assesses plant community composition by assigning coefficients of conservatism (C) to individual species based on their life history traits, including responses to disturbances. FQI should therefore reflect the community-level impacts of browsing as a disturbance, but little information exists on its use within forests or along browsing gradients. Here, we improved the classical measure of FQI by generating a new Floristic Quality Abundance Index (FQAI) that better captures plant community responses to disturbance. We then tested whether it reflects local densities of white-tailed deer (Odocoileus virginianus) and their impacts on forest understories using ground cover data from twelve sites across south-eastern Ontario, Canada. By excluding deer at five sites, we found that they preferentially removed plant species with lower C values, thereby explaining positive relationships between deer densities and FQAI across our sites. We propose that FQAI is an assessment tool that may improve the effectiveness of limited conservation resources for monitoring deer impacts.

James B. Collip—Member of the Canadian Team That Isolated Insulin

From the Mayo Clinic, Rochester, MN (M.A.S., R.A.K.); and Dana-Farber Cancer Institute, Boston, MA (D.P.S.). A mong the many controversial inclusions and exclusions in the history of Nobel laureate selections, the most widely known erroneous omission of a deserving candidate occurred when the 1923 Nobel Prize in physiology or medicine for the discovery of insulindthe hormone that regulates glucosedwas awarded to Frederick G. Banting (1891-1941) and John James R. Macleod (1876-1935) at the University of Toronto. Banting was particularly angry about this choice, arguing that Macleod was only a department chair and was not involved with the work, and that instead medical student Charles H. Best (1899-1978) deserved a share of the award. Banting shared part of his prize money with Best. Macleod in turn gave part of his Nobel award to biochemist James Bertram Collip, who he recruited to Toronto and who had isolated and purified insulin from pancreatic extract. (In 1916, Romanian physiologist Nicolae Paulescu [1869-1931] had prepared a less pure bovine pancreatic extract called pancreine, which contained enough insulin to normalize glucose levels in hyperglycemic dogs.) Collip was born on November 20, 1892, in rural Belleville in southeastern Ontario, about 50 miles west of Kingston. He received his early education in a one-room country school and entered Trinity College, University of Toronto, in 1908. After graduating in 1912 with a major in physiology and biochemistry, followed by completion of a PhD degree in biochemistry in 1916, he joined the faculty of the University of Alberta in Edmonton, Alberta. In 1921, he was awarded a Rockefeller Traveling Fellowship, which allowed him to work with Banting and Best in Macleod’s department in Toronto. While at the University of Toronto, Collip developed a method for the quantitative measurement of insulin in pancreatic extract and succeeded in isolating and purifying insulin (1921), thus making it available for therapeutic

A spatial analysis of private well water Escherichia coli contamination in southern Ontario

Research to date has provided limited insight into the complexity of water-borne pathogen transmission. Private well water supplies have been identified as a significant pathway in infectious disease transmission in both the industrialised and the developing world. Using over 90,000 private well water submission records representing approximately 30,000 unique well locations in south-eastern Ontario, Canada, a spatial analysis was performed in order to delineate clusters with elevated risk of E. coli contamination using 5 years of data (2008-2012). Analyses were performed for all years independently and subsequently compared to each other. Numerous statistically significant clusters were identified and both geographic stability and variation over time were examined. Through the identification of spatial and temporal patterns, this study provides the basis for future investigations into the underlying causes of bacterial groundwater contamination, while identifying geographic regions that merit particular attention to public health interventions and improvement of water quality.

Wetland mapping with LiDAR derivatives, SAR polarimetric decompositions, and LiDAR–SAR fusion using a random forest classifier

In this paper, we assess the use of Random Forest (RF) for mapping land cover classes within Mer Bleue bog, a large northern peatland in southeastern Ontario near Ottawa, Canada, using Synthetic Aperture Radar (SAR) and airborne Light Detection and Ranging (LiDAR). Not only has RF been shown to improve classification accuracies over more traditional classifiers, but it also provides useful information on the statistical importance of individual input image bands for land cover classification. Our specific objectives in this study were to: (i) assess the robustness of a RF approach to northern peatland classification; (ii) examine variable importance resulting from the RF classifications to identify which imagery types, derivatives, and analysis scales are most useful for mapping different classes of northern peatlands; (iii) assess if fusion of different LiDAR and SAR variables can improve classification accuracies at Mer Bleue; and (iv) assess physical interpretability of the multisensor image types and derivatives with respect to biophysical attributes associated with peatland classes. Our results show that the fusion of SAR with LiDAR imagery and derivatives at this study site did not provide additional classification accuracy over the use of LiDAR derivatives alone. Nevertheless, the RF-based approach presented here has strong potential to improve mapping and imagery classification of wetlands and may also help researchers and practitioners improve information extraction and land cover classification in other application areas benefitting from large volumes of multi-sensor imagery.

Evaluating the Change in Bladder Volume in Prostate Cancer Patients with a Standard Dose Regimen of Curative Radiation Therapy at the Cancer Centre of Southeastern Ontario

At the Cancer Centre of Southeastern Ontario, patients with intermediate risk prostate cancer were offered curative intensity modulated radiation therapy in a single phase (7800 centiGray in 38 treatments 7.5 weeks). Patients received full bladder preparation instructions before planning and treatment; a protocol that has been suggested to lower the toxicity to genitourinary and gastrointestinal structures. The aim of this study was to measure bladder volume consistency by comparing their computed tomography (CT) treatment planning scan to their first treatment cone beam computed tomography (CBCT) scan and the final CBCT.

Promoting Environmental Stewardship through gardens: A case study of children’s views of an urban school garden

Fostering children’s relationships with nature to develop their sense of environmental stewardship is an important means for redressing damage to the planet caused by human consumption and our collective failure to connect with the natural world. School garden programs provide a potentially meaningful way to promote children’s sense of connection to nature. This paper describes findings from an 8-month qualitative study investigating how a school garden program at one public elementary school in southeastern Ontario promoted the students’ sense of environmental stewardship. Data collected from eight students through observations, semi-structured interviews, and students’ photographs identified five broad themes associated with enhancing environmental stewardship for children (including connecting with nature, caretaking, and harvesting) as well as three broad themes that help explain the long-term success of the venture (including parental involvement and community connections). The discussion highlights some of the benefits of the school garden program, as well as some of the difficulties associated with the program and limitations of the study.

Y‐chromosome evidence supports asymmetric dog introgression into eastern coyotes

Hybridization has played an important role in the evolutionary history of Canis species in eastern North America. Genetic evidence of coyote–dog hybridization based on mitochondrial DNA (mtDNA) is lacking compared to that based on autosomal markers. This discordance suggests dog introgression into coyotes has potentially been male biased, but this hypothesis has not been formally tested. Therefore, we investigated biparentally, maternally, and paternally inherited genetic markers in a sample of coyotes and dogs from southeastern Ontario to assess potential asymmetric dog introgression into coyotes. Analysis of autosomal microsatellite genotypes revealed minimal historical and contemporary admixture between coyotes and dogs. We observed only mutually exclusive mtDNA haplotypes in coyotes and dogs, but we observed Y-chromosome haplotypes (Y-haplotypes) in both historical and contemporary coyotes that were also common in dogs. Species-specific Zfy intron sequences of Y-haplotypes shared between coyotes and dogs confirmed their homology and indicated a putative origin from dogs. We compared Y-haplotypes observed in coyotes, wolves, and dogs profiled in multiple studies, and observed that the Y-haplotypes shared between coyotes and dogs were either absent or rare in North American wolves, present in eastern coyotes, but absent in western coyotes. We suggest the eastern coyote has experienced asymmetric genetic introgression from dogs, resulting from predominantly historical hybridization with male dogs and subsequent backcrossing of hybrid offspring with coyotes. We discuss the temporal and spatial dynamics of coyote–dog hybridization and the conditions that may have facilitated the introgression of dog Y-chromosomes into coyotes. Our findings clarify the evolutionary history of the eastern coyote.

The changing prevalence of autism in three regions of Canada

In 2002/2003, the National Epidemiologic Database for the Study of Autism in Canada started capturing information on children diagnosed with autism in different regions of the country. Based on data collected through 2008 in Newfoundland and Labrador and 2010 in Prince Edward Island and Southeastern Ontario, the estimated average annual percent increases in prevalence among children 2-14years of age ranged from 9.7% (95% CI 7.8-11.6) to 14.6% (95% CI 11.3-18.0). Differential in-migration and identification of previously undetected cases may have contributed in part to the increases observed, but we cannot rule out the possibility of a true increase in incidence, particularly given the lack of a leveling-off of prevalence among the 6- to 9-year olds.

Fire regime zonation under current and future climate over eastern Canada

Fire is a major disturbance in Canadian forests. Along with fuel and ignition characteristics, climatic conditions are seen as one of the main drivers of fire regimes. Projected changes in climate are expected to significantly influence fire regimes in Canada. As fire regime greatly shapes large-scale patterns in biodiversity, carbon, and vegetation, as well as forest and fire management strategies, it becomes necessary to define regions where current and future fire regimes are homogeneous. Random Forests (RF) modeling was used to relate fire regime attributes prevailing between 1961 and 1990 in eastern Canada with climatic/fire-weather and environmental variables. Using climatic normals outputs from the Canadian Regional Climate Model (CRCM), we delineated current (1961-1990) and future (2011-2040, 2040-2070, 2071 2100) homogeneous fire regime (HFR) zones. Heterogeneous response of fire regime to climate changes is projected for eastern Canada with some areas (e.g., western Quebec) experiencing very small alterations while others (e.g., southeastern Ontario) are facing great shifts. Overall, models predicted a 2.2- and 2.4-fold increase in the number of fires and the annual area burned respectively mostly as a result of an increase in extreme fire-weather normals and mean drought code. As extreme fire danger would occur later in the fire season on average, the fire season would shift slightly later (5-20 days) in the summer for much of the study area while remaining relatively stable elsewhere. Although fire regime values would change significantly over time, most zone boundaries would remain relatively stable. The information resulting from HFR zonations is clearly of interest for forest and fire management agencies as it reveals zones with peculiar fire regimes that would have been hidden otherwise using predefined administrative or ecological stratifications.

Real-World Impact of Granulocyte-Colony Stimulating Factor on Febrile Neutropenia

Primary prophylaxis with granulocyte colony-stimulating factors (pp-g-csf) is recommended in patients undergoing chemotherapy carrying a febrile neutropenia (fn) risk of 20% or more. In the present study, we examined clinical practice patterns and the impact of pp-g-csf on fn incidence in women with early-stage breast cancer (ebc) treated with modern adjuvant chemotherapy (act). This single-centre retrospective cohort study of women with ebc, who were identified from the pharmacy database and who received at least 1 cycle of modern act from January 2009 to December 2011, was conducted at the Cancer Centre of Southeastern Ontario. Data on patient demographics, pathology, stage distribution, chemotherapy, pp-g-csf use, dose reductions, chemotherapy delays, treatment discontinuation, relative dose intensity, and fn events were collected. Chi-square tests, t-tests, univariate and multivariate logistic regression analyses, and nonparametric Mann-Whitney U-tests were used for data analysis. Of the 239 women eligible for analysis, 145 (61%) received pp-g-csf, and 50 (21%) developed at least 1 episode of fn. Use of pp-g-csf was associated with a significantly lower rate of fn (14% vs. 31%, p = 0.002) and trends to fewer dose delays (17% vs. 27%, p = 0.060) and dose reductions (19% vs. 25%, p = 0.28). Among women receiving pp-g-csf, higher fn rates were associated with an age of 65 years or older, taxane-based chemotherapy, and prophylaxis with filgrastim. Clinical practice patterns at our institution showed that more than 50% of ebc patients treated with modern act received pp-g-csf, which led to fewer fn episodes and increased delivery of planned act. The observed high fn risk despite pp-g-csf was linked to older age, taxane-based chemotherapy, and filgrastim.

A retrospective study on the role of diabetes and metformin in colorectal cancer disease progression.

1593 Background: Recent studies have suggested a potential epidemiological role for diabetes as an independent risk factor for the development of colorectal cancer (CRC). These studies have furthermore suggested patients with diabetes who develop colorectal cancer have an increased mortality. Methods: To identify a potential correlation between CRC and diabetes, we are performing a retrospective chart review of CRC patients treated at the Cancer Center of Southeastern Ontario diagnosed from January 2005 to December 2011. 1,300 colorectal cancer patient charts have been identified through Ontario Cancer Registry Data based on confirmed ICD-10 diagnosis codes and the variables of 200 random patients have been extracted into our database thus far. The final analysis will be completed April 2013. Results: Preliminary analysis of the database has indicated that the average age of patients with CRC was 69 years with 55% being women. The incidence of diabetes in our CRC population was 19%, double the rate of diabetes in the general population in Canada. As expected, the rate of co-morbidities excluding diabetes was higher in the diabetic group (92.9% vs 69.3%; p=0.004). When we looked at the diabetic population specifically, the rate of death was not significantly different compared to the non-diabetic population (13.2% vs 12.7%, p=0.94), however those with diabetes presented with later-stage (stage 2/3/4) disease (92.1% versus 88.6%). The average number of days from the time of diagnosis to death in the diabetic group (200 days) was half compared to the non-diabetic group (420 days, p=0.014). However, there was no statistical difference in the percentage of progression, number of different metastatic sites or the burden of metastatic disease amongst the two populations. A subgroup analysis of diabetic patients on metformin illustrated that the death rate (p=0.06), rate of progression (33% vs 20%) and those presenting with later stage disease was higher in patients not on metformin compared to those on the drug. Conclusions: Our preliminary work suggests diabetics with CRC may have a worst prognosis however taking metformin may have a positive impact on prognosis.