European Prospective Investigation into Cancer and Nutrition
Encyclopedia
The European Prospective Investigation into Cancer and Nutrition (EPIC) study is a Europe
-wide prospective cohort study
of the relationships between diet
and cancer
, as well as other chronic diseases, such as cardiovascular disease
. With over half a million participants, it is the largest study of diet and disease to be undertaken.
EPIC is coordinated by the International Agency for Research on Cancer
(IARC), part of the World Health Organization
, and funded by the 'Europe Against Cancer' programme of the European Commission
as well as multiple nation-specific grants and charities.
521,457 healthy adults, mostly aged 35–70 years, were enrolled in 23 centres in ten European countries: Denmark
(11%), France
(14%), Germany
(10%), Greece
(5%), Italy
(9%), The Netherlands (8%), Norway
(7%), Spain
(8%), Sweden
(10%) and the United Kingdom
(17%). One UK centre (Oxford) recruited 27,000 vegetarians and vegans; this subgroup forms the largest study of this dietary group. Recruitment to the study took place between 1993 and 1999, and follow up is planned for at least ten years, with repeat interview/questionnaires every three to five years. The main prospective data collected are standardised dietary questionnaire
s (self administered or interview based), seven-day food diaries, blood samples and anthropometric measurements, such as body mass index
and waist-to-hip ratio. Additionally, the GenAir case-control study is studying the relationship of passive smoking
and air pollution
with cancers and respiratory disease
s.
Up to 2004, there were over 26,000 new cases of cancer recorded among participants, with the most common being cancers of the breast, colorectum, prostate and lung. Current analyses are focusing particularly on stomach
, colorectal
, breast
, prostate
and lung
cancers. The different dietary patterns in the different countries should enable reliable associations to be made between particular diets and cancers. The analysis of stored blood samples should also allow dissection of genetic factors involved in cancers, as well as the effects of hormone
s and hormone-like factors.
Europe
Europe is, by convention, one of the world's seven continents. Comprising the westernmost peninsula of Eurasia, Europe is generally 'divided' from Asia to its east by the watershed divides of the Ural and Caucasus Mountains, the Ural River, the Caspian and Black Seas, and the waterways connecting...
-wide prospective cohort study
Cohort study
A cohort study or panel study is a form of longitudinal study used in medicine, social science, actuarial science, and ecology. It is an analysis of risk factors and follows a group of people who do not have the disease, and uses correlations to determine the absolute risk of subject contraction...
of the relationships between diet
Diet (nutrition)
In nutrition, diet is the sum of food consumed by a person or other organism. Dietary habits are the habitual decisions an individual or culture makes when choosing what foods to eat. With the word diet, it is often implied the use of specific intake of nutrition for health or weight-management...
and cancer
Cancer
Cancer , known medically as a malignant neoplasm, is a large group of different diseases, all involving unregulated cell growth. In cancer, cells divide and grow uncontrollably, forming malignant tumors, and invade nearby parts of the body. The cancer may also spread to more distant parts of the...
, as well as other chronic diseases, such as cardiovascular disease
Cardiovascular disease
Heart disease or cardiovascular disease are the class of diseases that involve the heart or blood vessels . While the term technically refers to any disease that affects the cardiovascular system , it is usually used to refer to those related to atherosclerosis...
. With over half a million participants, it is the largest study of diet and disease to be undertaken.
EPIC is coordinated by the International Agency for Research on Cancer
International Agency for Research on Cancer
The International Agency for Research on Cancer is an intergovernmental agency forming part of the World Health Organisation of the United Nations....
(IARC), part of the World Health Organization
World Health Organization
The World Health Organization is a specialized agency of the United Nations that acts as a coordinating authority on international public health. Established on 7 April 1948, with headquarters in Geneva, Switzerland, the agency inherited the mandate and resources of its predecessor, the Health...
, and funded by the 'Europe Against Cancer' programme of the European Commission
European Commission
The European Commission is the executive body of the European Union. The body is responsible for proposing legislation, implementing decisions, upholding the Union's treaties and the general day-to-day running of the Union....
as well as multiple nation-specific grants and charities.
521,457 healthy adults, mostly aged 35–70 years, were enrolled in 23 centres in ten European countries: Denmark
Denmark
Denmark is a Scandinavian country in Northern Europe. The countries of Denmark and Greenland, as well as the Faroe Islands, constitute the Kingdom of Denmark . It is the southernmost of the Nordic countries, southwest of Sweden and south of Norway, and bordered to the south by Germany. Denmark...
(11%), France
France
The French Republic , The French Republic , The French Republic , (commonly known as France , is a unitary semi-presidential republic in Western Europe with several overseas territories and islands located on other continents and in the Indian, Pacific, and Atlantic oceans. Metropolitan France...
(14%), Germany
Germany
Germany , officially the Federal Republic of Germany , is a federal parliamentary republic in Europe. The country consists of 16 states while the capital and largest city is Berlin. Germany covers an area of 357,021 km2 and has a largely temperate seasonal climate...
(10%), Greece
Greece
Greece , officially the Hellenic Republic , and historically Hellas or the Republic of Greece in English, is a country in southeastern Europe....
(5%), Italy
Italy
Italy , officially the Italian Republic languages]] under the European Charter for Regional or Minority Languages. In each of these, Italy's official name is as follows:;;;;;;;;), is a unitary parliamentary republic in South-Central Europe. To the north it borders France, Switzerland, Austria and...
(9%), The Netherlands (8%), Norway
Norway
Norway , officially the Kingdom of Norway, is a Nordic unitary constitutional monarchy whose territory comprises the western portion of the Scandinavian Peninsula, Jan Mayen, and the Arctic archipelago of Svalbard and Bouvet Island. Norway has a total area of and a population of about 4.9 million...
(7%), Spain
Spain
Spain , officially the Kingdom of Spain languages]] under the European Charter for Regional or Minority Languages. In each of these, Spain's official name is as follows:;;;;;;), is a country and member state of the European Union located in southwestern Europe on the Iberian Peninsula...
(8%), Sweden
Sweden
Sweden , officially the Kingdom of Sweden , is a Nordic country on the Scandinavian Peninsula in Northern Europe. Sweden borders with Norway and Finland and is connected to Denmark by a bridge-tunnel across the Öresund....
(10%) and the United Kingdom
United Kingdom
The United Kingdom of Great Britain and Northern IrelandIn the United Kingdom and Dependencies, other languages have been officially recognised as legitimate autochthonous languages under the European Charter for Regional or Minority Languages...
(17%). One UK centre (Oxford) recruited 27,000 vegetarians and vegans; this subgroup forms the largest study of this dietary group. Recruitment to the study took place between 1993 and 1999, and follow up is planned for at least ten years, with repeat interview/questionnaires every three to five years. The main prospective data collected are standardised dietary questionnaire
Questionnaire
A questionnaire is a research instrument consisting of a series of questions and other prompts for the purpose of gathering information from respondents. Although they are often designed for statistical analysis of the responses, this is not always the case...
s (self administered or interview based), seven-day food diaries, blood samples and anthropometric measurements, such as body mass index
Body mass index
The body mass index , or Quetelet index, is a heuristic proxy for human body fat based on an individual's weight and height. BMI does not actually measure the percentage of body fat. It was invented between 1830 and 1850 by the Belgian polymath Adolphe Quetelet during the course of developing...
and waist-to-hip ratio. Additionally, the GenAir case-control study is studying the relationship of passive smoking
Passive smoking
Passive smoking is the inhalation of smoke, called secondhand smoke or environmental tobacco smoke , from tobacco products used by others. It occurs when tobacco smoke permeates any environment, causing its inhalation by people within that environment. Exposure to secondhand tobacco smoke causes...
and air pollution
Air pollution
Air pollution is the introduction of chemicals, particulate matter, or biological materials that cause harm or discomfort to humans or other living organisms, or cause damage to the natural environment or built environment, into the atmosphere....
with cancers and respiratory disease
Respiratory disease
Respiratory disease is a medical term that encompasses pathological conditions affecting the organs and tissues that make gas exchange possible in higher organisms, and includes conditions of the upper respiratory tract, trachea, bronchi, bronchioles, alveoli, pleura and pleural cavity, and the...
s.
Up to 2004, there were over 26,000 new cases of cancer recorded among participants, with the most common being cancers of the breast, colorectum, prostate and lung. Current analyses are focusing particularly on stomach
Stomach cancer
Gastric cancer, commonly referred to as stomach cancer, can develop in any part of the stomach and may spread throughout the stomach and to other organs; particularly the esophagus, lungs, lymph nodes, and the liver...
, colorectal
Colorectal cancer
Colorectal cancer, commonly known as bowel cancer, is a cancer caused by uncontrolled cell growth , in the colon, rectum, or vermiform appendix. Colorectal cancer is clinically distinct from anal cancer, which affects the anus....
, breast
Breast cancer
Breast cancer is cancer originating from breast tissue, most commonly from the inner lining of milk ducts or the lobules that supply the ducts with milk. Cancers originating from ducts are known as ductal carcinomas; those originating from lobules are known as lobular carcinomas...
, prostate
Prostate cancer
Prostate cancer is a form of cancer that develops in the prostate, a gland in the male reproductive system. Most prostate cancers are slow growing; however, there are cases of aggressive prostate cancers. The cancer cells may metastasize from the prostate to other parts of the body, particularly...
and lung
Lung cancer
Lung cancer is a disease characterized by uncontrolled cell growth in tissues of the lung. If left untreated, this growth can spread beyond the lung in a process called metastasis into nearby tissue and, eventually, into other parts of the body. Most cancers that start in lung, known as primary...
cancers. The different dietary patterns in the different countries should enable reliable associations to be made between particular diets and cancers. The analysis of stored blood samples should also allow dissection of genetic factors involved in cancers, as well as the effects of hormone
Hormone
A hormone is a chemical released by a cell or a gland in one part of the body that sends out messages that affect cells in other parts of the organism. Only a small amount of hormone is required to alter cell metabolism. In essence, it is a chemical messenger that transports a signal from one...
s and hormone-like factors.
Key findings
The study and its analysis is ongoing, but key results of the study retrieved in 2008 are:- Lowered sodium from salt intake, high potassium from fruit and vegetable consumption promote healthy blood pressure levels.
- High physical activity, involving some high impact activities is a good indicator of longevity and low risk of bone fractures
- High dietary fibre protects against bowel cancer
- Obesity increases a number of cancer risks
- High levels of sex hormones increase risk of breast cancer
- Increased fat intake increases the risk of breast cancer
- Increases in eating fruit and vegetables reduces the risk from all causes of an early death
- High blood glucose levels are associated with increased risk of heart disease.
- The combined impact of four behaviours – not smoking, being physically active, moderate alcohol intake and the consumption of at least five fruit and vegetable servings a day – was estimated to amount to 14 additional years of life (Khaw et al. 2008).
External links
- EPIC project (IARC)
- EPIC study (CR UK)
- EPIC (Oxford centre) (preferentially recruited vegetarians & vegans)
- EPIC-Norfolk (UK Norfolk cohort)