Leah Smith, recipient of Lise Manchester Award 2020
The 2020 Lise Manchester Award is conferred upon Leah Smith of the Canadian Cancer Society (CCS). This award is given every other year by the Statistical Society of Canada to commemorate the late Dr. Lise Manchester’s abiding interest in using statistical methods to study matters of relevance to society. The award recognizes excellence in statistical research that helps guide public policy in Canada.
Leah is currently senior manager for surveillance at the CCS, chairs the Canadian Cancer Statistics Advisory Committee and is a member of the Canadian Council of Cancer Registries and the Pan-Canadian Cervical Cancer Screening Network. She has conducted many local and national print, radio, and TV interviews.
Following her BSc in Psychology from Memorial University of Newfoundland, Leah was trained in epidemiology. She received an MSc in 2010 from Queen’s University where her thesis work addressed the use and safety of the quadrivalent human papilloma virus (HPV) vaccine in Grade 8 girls, and a PhD in 2014 from McGill University for her thesis “The Impact of Human Papillomavirus Vaccination on Adolescent Health Outcomes: An Application of the Regression Discontinuity Design.” Following a postdoctoral fellowship at Queen’s University’s Department of Public Health Sciences and Centre for Health Services and Policy she joined the Canadian Cancer Society as an epidemiologist in 2015.
The award is for her work, published in the Canadian Medical Association Journal (2015), Pediatrics (2015) and the International Journal of Epidemiology (2017) that addressed the real-world impacts and possible unintended consequences of HPV vaccination campaigns and programs. These issues cannot be answered by randomized controlled trials and nonexperimental studies using standard tools are likely to be biased. They therefore must be addressed using rigorous methods that are capable of measuring causal effects. In her first article Leah asked whether HPV immunization programs or the receipt of the vaccine itself affect sexual behaviour among teenage girls. She combined a novel and complex quasi-experimental method, regression discontinuity, with high-quality administrative health data and a sound understanding of the policy context. Under appropriate conditions this method provides unbiased estimates and is not subject to confounding in the same way that standard tools are. Leah’s was the first study to plausibly estimate the causal effect of HPV vaccination on risky sexual behaviours. She found that neither the implementation of Ontario’s HPV program nor receipt of the vaccine itself lead to changes in rates of pregnancy or sexually transmitted infections.
These results were and still are important for policymakers, health professionals, parents, and young adults. Informing parents and the wider public regarding the scientific evidence of the costs and benefits of vaccines for young people continues to be an important health policy challenge. Her CMAJ article received widespread media attention, including in the CBC, the Globe and Mail and the Wall Street Journal. Leah’s second article, a clinically important and policy relevant evaluation of the effect of the Ontario HPV vaccine policy, and of the vaccine itself, on cervical dysplasia and anogenital warts in adolescent girls reached a large clinical audience and received significant media attention. Her third article, in a top epidemiology journal with a strong methodological bent, guides other researchers to responsibly and productively use the regression discontinuity design.
The citation for the award reads:
“To Leah Smith, for her influential work on the positive effects, and the lack of negative effects, of Ontario's HPV vaccination program; and for showing how the use of rigorous statistical methods, quasi-experimental settings and population-based provincial administrative data can make significant contributions to improving health and health care systems in Canada and elsewhere.”
James Hanley was primarily responsible for producing this material.