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| EPIC (European Prospective Investigation into Cancer and Nutrition) | |
|---|---|
| Name | European Prospective Investigation into Cancer and Nutrition |
| Acronym | EPIC |
| Start date | 1992 |
| Countries | Belgium, Denmark, France, Germany, Greece, Italy, Netherlands, Norway, Spain, Sweden, United Kingdom, United Kingdom: Scotland, United Kingdom: England, Czech Republic, Poland, Romania, Russia |
| Principal investigators | Timothy J. Key, Elio Riboli |
| Participants | ~520,000 |
| Fields | Epidemiology, Nutrition, Oncology, Public health |
EPIC (European Prospective Investigation into Cancer and Nutrition) is a multinational cohort study initiated to investigate relationships between diet, lifestyle, environmental factors and the incidence of chronic diseases, primarily cancer. Launched in the early 1990s and coordinated from International Agency for Research on Cancer and Imperial College London centers, the project enrolls over half a million participants across multiple European centers and links dietary exposure data with cancer outcomes and biomarker information. EPIC has generated extensive pooled data used by researchers affiliated with institutions such as University of Oxford, Karolinska Institutet, Inserm, and German Cancer Research Center.
EPIC was conceived during meetings involving scientists from World Health Organization and European Commission research programs and established formal collaborations among national centers including IARC, MRC Epidemiology Unit, Institut Gustave Roussy, and National Cancer Institute (United States). The study's objectives include quantifying associations between nutrient intake and cancer risk, understanding variation across populations such as those in Greece, Italy, Spain, Sweden, United Kingdom, France, Germany, Netherlands and assessing biomarkers in nested case–control analyses. Leadership and advisory roles have involved figures linked to University of Cambridge, ETH Zurich, University of Milan, and University College London.
EPIC is a prospective cohort combining regional cohorts from centers in countries including Belgium, Denmark, Norway, Poland, Czech Republic, Romania and the United Kingdom. Recruitment focused on adults aged predominantly 35–70 years, with subcohorts such as the Oxford-Vegetarian Study overlap and cohorts linked to EPIC-Norfolk and EPIC-Italy. The study uses standardized protocols influenced by practices at Harvard School of Public Health and harmonization efforts with consortia like Cohorts for Heart and Aging Research in Genomic Epidemiology to enable pooled analyses across diverse populations including participants from Lombardy, Catalonia, Bordeaux, Utrecht and Aarhus.
Baseline data collection employed food-frequency questionnaires adapted from methods used at Harvard and validated against 24-hour recalls and biomarkers measured in laboratories such as University of Cambridge Biochemistry Unit and Karolinska Institutet facilities. Anthropometry and lifestyle questionnaires borrowed approaches from cohorts like Framingham Heart Study and Nurses' Health Study. Biological specimens include cryopreserved plasma, serum, urine and buffy coat samples stored in biobanks at centers including IARC Biobank, Inserm Biobank and local repositories in Milan and Oxford. Outcome ascertainment uses cancer registries such as Surveillance, Epidemiology, and End Results Program analogues in European countries and linkage with mortality databases like those maintained by Eurostat.
EPIC publications have addressed diet–cancer associations including links between red and processed meat and colorectal cancer, dietary fiber and reduced colorectal risk, and alcohol consumption and breast cancer risk; these reports appear in journals connected to editorial boards with members from The Lancet, BMJ, International Journal of Epidemiology and Cancer Epidemiology, Biomarkers & Prevention. Key pooled analyses implicated biomarkers such as plasma carotenoids, vitamin D metabolites and fatty acid profiles in risk stratification, reported by investigators affiliated with University of Glasgow, Utrecht University, University of Navarra, Bologna University and University of Heidelberg. EPIC findings have been cited alongside work from World Cancer Research Fund and American Institute for Cancer Research reports.
Strengths include large sample size, geographic diversity across Europe, extensive biospecimen collection, and capacity for nested case–control and biomarker studies enabling collaborations with groups at Broad Institute and Max Planck Institute for Demographic Research. Harmonization across centers benefited from protocols influenced by European Respiratory Health Survey and statistical methods developed in part with researchers from London School of Hygiene & Tropical Medicine and Columbia University. Limitations noted in EPIC publications include measurement error in dietary assessment similar to issues discussed in Nurses' Health Study critiques, potential residual confounding acknowledged by analysts connected to Johns Hopkins Bloomberg School of Public Health, and differential follow-up related to national cancer registry completeness in countries such as Romania and Poland.
EPIC has spawned substudies and collaborative projects including EPIC-InterAct, EPIC-Oxford and nested case–control analyses in partnership with institutions like University of Cambridge, McMaster University, University of Toronto and University of California, Berkeley. Genetic and metabolomic investigations have linked EPIC data with consortia such as Genetic Investigation of ANthropometric Traits and Meta-Analyses of Glucose and Insulin-related traits Consortium and involved laboratories at Wellcome Sanger Institute, European Molecular Biology Laboratory and Helmholtz Zentrum München.
Results from EPIC have informed dietary guidelines and risk assessments cited by bodies including World Health Organization, European Food Safety Authority, National Institute for Health and Care Excellence and national ministries of health in France and United Kingdom. EPIC evidence contributed to reports by International Agency for Research on Cancer on processed meat classification and influenced prevention strategies referenced by European Commission initiatives and public health agencies such as Public Health England and Health Protection Scotland.
Category:Cohort studies Category:Cancer epidemiology