European Prospective Investigation into Cancer and Nutrition (EPIC): study populations and data collection | Public Health Nutrition | Cambridge Core (original) (raw)

Abstract

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The European Prospective Investigation into Cancer and Nutrition (EPIC) is an ongoing multi-centre prospective cohort study designed to investigate the relationship between nutrition and cancer, with the potential for studying other diseases as well. The study currently includes 519 978 participants (366 521 women and 153 457 men, mostly aged 35–70 years) in 23 centres located in 10 European countries, to be followed for cancer incidence and cause-specific mortality for several decades. At enrolment, which took place between 1992 and 2000 at each of the different centres, information was collected through a non-dietary questionnaire on lifestyle variables and through a dietary questionnaire addressing usual diet. Anthropometric measurements were performed and blood samples taken, from which plasma, serum, red cells and buffy coat fractions were separated and aliquoted for long-term storage, mostly in liquid nitrogen. To calibrate dietary measurements, a standardised, computer-assisted 24-hour dietary recall was implemented at each centre on stratified random samples of the participants, for a total of 36 900 subjects. EPIC represents the largest single resource available today world-wide for prospective investigations on the aetiology of cancers (and other diseases) that can integrate questionnaire data on lifestyle and diet, biomarkers of diet and of endogenous metabolism (e.g. hormones and growth factors) and genetic polymorphisms. First results of case–control studies nested within the cohort are expected early in 2003. The present paper provides a description of the EPIC study, with the aim of simplifying reference to it in future papers reporting substantive or methodological studies carried out in the EPIC cohort.

References

1Tannenbaum, A. Initiation and growth of tumors; introduction: effects of underfeeding. Am. J. Cancer 1940; 39: 335–50.Google Scholar

2Doll, R, Payne, P, Waterhouse, J. Cancer Incidence in Five Continents: A Technical Report. Berlin: Springer, 1966.CrossRefGoogle Scholar

3Doll, R, Payne, P, Waterhouse, J. Cancer Incidence in Five Continents. Berlin: Springer, 1970.CrossRefGoogle Scholar

4Armstrong, B, Doll, R. Environmental factors and cancer incidence and mortality in different countries, with special reference to dietary practices. Int. J. Cancer 1975; 15: 617–31.CrossRefGoogle ScholarPubMed

5World Cancer Research Fund/American Institute of Cancer Research (WCRF/AICR). Food, Nutrition and the Prevention of Cancer: A Global Perspective. Washington, DC: WCRF/AICR, 1997.Google Scholar

6Riboli, E. Nutrition and cancer: background and rationale of the European Prospective Investigation into Cancer and Nutrition (EPIC). Ann. Oncol. 1992; 3: 783–91.CrossRefGoogle ScholarPubMed

7Riboli, E. The European Prospective Investigation into Cancer and Nutrition: perspectives for cancer prevention. Nestle Nutr. Workshop Ser. Clin. Perform. Programme 2000; 4: 117–30.CrossRefGoogle ScholarPubMed

8Riboli, E. The European Prospective Investigation into Cancer and Nutrition (EPIC): plans and progress. J. Nutr. 2001; 131: 170S–5S.CrossRefGoogle ScholarPubMed

9Riboli, E, Kaaks, R. The EPIC Project: rationale and study design. European Prospective Investigation into Cancer and Nutrition. Int. J. Epidemiol. 1997; 26(Suppl. 1): S6–14.CrossRefGoogle ScholarPubMed

10Riboli, E, Kaaks, R. Invited commentary: the challenge of multi-center cohort studies in the search for diet and cancer links. Am. J. Epidemiol. 2000; 151: 371–4.CrossRefGoogle ScholarPubMed

11Berglund, G, Elmstahl, S, Janzon, L, Larsson, SA. The Malmö Diet and Cancer Study. Design and feasibility. J. Intern. Med. 1993; 233: 45–51.CrossRefGoogle Scholar

12Clavel-Chapelon, F, van Liere, MJ, Giubout, C, Niravong, MY, Goulard, H, Le Corre, C, et al. E3N, a French cohort study on cancer risk factors. E3N Group. Etude Epidémiologique auprès de femmes de l'Education Nationale. Eur. J. Cancer Prev. 1997; 6: 473–8.Google ScholarPubMed

13Hjartåker, A, Lund, E. Relationship between dietary habits, age, lifestyle, and socio-economic status among adult Norwegian women. The Norwegian Women and Cancer Study. Eur. J. Clin. Nutr. 1998; 52: 565–72.CrossRefGoogle ScholarPubMed

14Boeing, H, Wahrendorf, J, Becker, N. EPIC–Germany – a source for studies into diet and risk of chronic diseases. Ann. Nutr. Metab. 1999; 43: 195–204.CrossRefGoogle ScholarPubMed

15Boeing, H, Korfmann, A, Bergmann, MM. Recruitment procedures of EPIC–Germany. European Investigation into Cancer and Nutrition. Ann. Nutr. Metab. 1999; 43: 205–15.CrossRefGoogle ScholarPubMed

16Day, N, Oakes, S, Luben, R, Khaw, KT, Bingham, S, Welch, A, et al. EPIC–Norfolk: study design and characteristics of the cohort. European Prospective Investigation of Cancer. Br. J. Cancer. 1999; 80(Suppl. 1): 95–103.Google Scholar

  1. Keinan-Boker, L, van Noord, PAH, van der Schouw, YT, Koot, NVCM, Bueno-de-Mesquita, HB, Riboli, E, et al. Prospect–EPIC Utrecht: study design and characteristics of the cohort population. Eur. J. Epidemiol. 2002; in press.Google Scholar

18Schulze, MD, Kroke, A, Saracci, R, Boeing, H. The effect of measurement procedure differences on the comparability of blood pressure estimates in multi-centre studies. Blood Press. Monit. 2000; 7: 95–104.CrossRefGoogle Scholar

19Overvad, K, Tjønneland, A, Haraldsdóttir, J, Bang, S, Ewertz, M, Møller-Jensen, O. Development of a semi-quantitative food frequency questionnaire to assess food, energy and nutrient intake in Denmark. Int. J. Epidemiol. 1991; 20: 906–12.CrossRefGoogle Scholar

20Bingham, SA, Gill, C, Welch, A, Day, K, Cassidy, A, Khaw, KT, et al. Comparison of dietary assessment methods in nutritional epidemiology: weighted records v. 24 h recalls, food-frequency questionnaires and estimated-diet records. Br. J. Nutr. 1994; 72: 619–43.CrossRefGoogle Scholar

21Margetts, BM, Pietinen, P, Riboli, E, eds. EPIC: European Prospective Investigation into Cancer and Nutrition: validity studies on dietary assessment methods [special issue]. Int. J. Epidemiol. 1997; 26(Suppl. 1): S1–189.CrossRefGoogle Scholar

22Riboli, E, Elmståhl, S, Saracci, R, Gullberg, B, Lindgärde, F. The Malmö Food Study: validity of two dietary assessment methods for measuring nutrient intakes. Int. J. Epidemiol. 1997; 26: S161–71.CrossRefGoogle Scholar

23Kroke, A, Klipstein-Grobusch, K, Voss, S, Moseneder, J, Thielecke, F, Noack, R, et al. Validation of a self-administered food-frequency questionnaire administered in the European Prospective Investigation into Cancer and Nutrition (EPIC) Study: comparison of energy, protein, and macronutrient intakes estimated with the doubly labeled water, urinary nitrogen, and repeated 24-h dietary recall methods. Am. J. Clin. Nutr. 1999; 70: 439–47.CrossRefGoogle Scholar

24Slimani, N, Deharveng, G, Charrondière, RU, van Kappel, AL, Ocké, MC, Welch, A, et al. Structure of the standardized computerized 24-h diet recall interview used as reference method in the 22 centers participating in the EPIC project. European Prospective Investigation into Cancer and Nutrition. Comput. Meth. Programs Biomed. 1999; 58: 251–66.CrossRefGoogle ScholarPubMed

25Slimani, N, Ferrari, P, Ocké, M, Welch, A, Boeing, H, Liere, M, et al. Standardization of the 24-hour diet recall calibration method used in the European Prospective Investigation into Cancer and Nutrition (EPIC): general concepts and preliminary results. Eur. J. Clin. Nutr. 2000; 54: 900–17.CrossRefGoogle ScholarPubMed

26Slimani, N, Kaaks, R, Ferrari, P, Casagrande, C, Clavel-Chapelon, F, Lotze, G, et al. European Prospective Investigation into Cancer and Nutrition (EPIC) calibration study: rationale, design and population characteristics. Public Health Nutr. 2002; 5(6B): 1125–45.CrossRefGoogle ScholarPubMed

27Kaaks, R, Riboli, E. Validation and calibration of dietary intake measurements in the EPIC project: methodological considerations. European Prospective Investigation into Cancer and Nutrition. Int. J. Epidemiol. 1997; 26(Suppl. 1): S15–25.CrossRefGoogle ScholarPubMed

28Kaaks, R, Plummer, M, Riboli, E, Esteve, J, van Staveren, W. Adjustment for bias due to errors in exposure assessments in multicenter cohort studies on diet and cancer: a calibration approach. Am. J. Clin. Nutr. 1994; 59: 245S–50S.CrossRefGoogle Scholar

29Kaaks, R, Riboli, E, Esteve, J, van Kappel, AL, van Staveren, WA. Estimating the accuracy of dietary questionnaire assessments: validation in terms of structural equation models. Stat. Med. 1994; 13: 127–42.CrossRefGoogle ScholarPubMed

30Kaaks, R, Riboli, E, van Staveren, W. Sample size requirements for calibration studies of dietary intake measurements in prospective cohort investigations. Am. J. Epidemiol. 1995; 142: 557–65.CrossRefGoogle ScholarPubMed

31Kaaks, R, Riboli, E, van Staveren, W. Calibration of dietary intake measurements in prospective cohort studies. Am. J. Epidemiol. 1995; 142: 548–56.CrossRefGoogle ScholarPubMed

32Slimani, N, Charrondière, UR, van Staveren, W, Riboli, E. Standardization of food composition databases for the European Prospective Investigation into Cancer and Nutrition (EPIC): general theoretical concept. J. Food Comp. Anal. 2000; 13: 567–84.CrossRefGoogle Scholar

33Charrondière, UR, Vignat, J, Møller, A, Ireland, J, Becker, W, Church, S, et al. The European Nutrient Database (ENDB) for nutritional epidemiology. J. Food Comp. Anal. 2002; 15(4): 435–51.CrossRefGoogle Scholar

34Haftenberger, M, Lahmann, PH, Panico, S, González, CA, Seidell, JC, Boeing, H, et al. Overweight, obesity and body fat distribution in 50- to 64-year-old participants in the European Prospective Investigation into Cancer and Nutrition (EPIC). Public Health Nutr. 2002; 5(6B): 1147–62.CrossRefGoogle ScholarPubMed

35Ireland, J, van Erp-Baart, AMJ, Charrondière, UR, Møller, A, Smithers, G, Trichopoulou, A, for the EFCOSUM Group. Selection of a food classification system and a food composition database for future food consumption surveys. Eur. J. Clin. Nutr. 2002; 56(Suppl. 2): S33–45.CrossRefGoogle Scholar