European Prospective Investigation into Cancer and Nutrition (Network) (EPIC)

The European Prospective Investigation into Cancer and nutrition (EPIC) is a prospective cohort of 521,468 men and women enrolled from ten countries (UK, France, Spain, Italy, Germany, Netherlands, Greece, Sweden, Denmark and Norway). The planning and piloting of EPIC was initiated in 1990 by IARC-WHO and the participating centres, with support from the European Commission. When study participant recruitment began in 1992, detailed information on diet, comprehensive lifestyle characteristics, anthropometric measurements and medical history was collected. Biological samples including plasma, serum, leukocytes, and erythrocytes were collected from 387,889 individuals, and have been stored at the International Agency for Research on Cancer for the majority of centers, and at EPIC collaborating centers (Denmark and Sweden). Since recruitment, incident cancer cases have been identified via routine linkage to population-based cancer registries or by active follow-up. Mortality data, including vital status, cause of death, and date of death, have been obtained from mortality registries at the regional or national level. Up until 2009, over 63,000 EPIC participants had been diagnosed with incident cancer. It is anticipated that by 2020 this number will have risen to 90,000.

Overall, the EPIC biorepositories host over 9 million aliquots, constituting one of the largest biobanks in the world for genetic, biochemical and epidemiological research. The large number of incident cancer cases with prospectively collected lifestyle data and blood specimens allow state-of-the-art investigations into the etiology and prevention of cancer, as well as other chronic diseases.

General Information

Name: 
European Prospective Investigation into Cancer and Nutrition (Network)
Acronym: 
EPIC
Study Start Year: 
1992

General Design

Study design: 
Cohort study
General Information on Follow Up (profile and frequency): 

Recruitment of participants and data collection were completed in 1999. Follow-up of study participants for disease end-points, vital status, and causes of death started in the mid-1990s. Additional follow-up to measure changes in lifestyle, health conditions, diagnosed diseases, and related treatment was conducted a few years after baseline, at least once in all EPIC study centres.

Exposure follow-up: After their initial enrolment, cohort members were contacted at regular intervals every 3–5 years (depending on the country or centre) to obtain information on various aspects of lifestyle, which may change over time. These include dietary habits, tobacco smoking, alcohol consumption, physical activity, weight, menstruation, pregnancies, menopausal status, and other variables. In addition, a series of questions inquired about participants’ health status. Information on lifestyle exposures during follow-up will be centralized at IARC in 2014. In this way, EPIC can establish whether meaningful changes in lifestyle exposures have occurred among study participants since recruitment.

Recruitment target: 
Individuals
Target number of participants: 
521 468
Target number of participants with biological samples: 
387 889
Supplementary information about target number of participants: 

The following biospecimens are currently (October 2014) available from the EPIC study:

  • Plasma: 381 042 participants 
  • Serum: 342 012 participants
  • Buffy coat: 352 300 participants
  • Erythrocyte: 363 999 participants

Detailed numbers of participants per country are available in the Document Section. 

Supplementary information: 

EPIC is a multi-centre prospective cohort study designed to investigate the relation between diet, nutritional and metabolic characteristics, various lifestyle factors and the risk of cancer. The study is based in ten European countries and includes populations characterized by large variations in dietary habits and cancer risk. Data are collected on diet, physical activity, sexual maturation and reproductive history, lifetime consumption of alcohol and tobacco, previous and current illnesses and current medication. Following a common protocol and using identical equipment, blood samples are collected, aliquoted into plasma, serum, white blood cells and erythrocytes, and stored in liquid nitrogen at –196°C for future laboratory analyses on cancer cases and matched healthy controls. Anthropometric measurements are taken according to a standard protocol. It is planned to include around 400 000 middle-aged men and women.

Access

Access to external researchers or third parties provided or foreseen for
Data (questionnaire-derived, measured...): 
Yes
Biological samples: 
Yes

Marker Paper

Marker paper: 
Riboli 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.
Pubmed ID: 

Supplementary Information

Endpoints (N incident cases)

Cancer (as of November 2015)
Head and Neck (C00-C14; C31, C32) = 1,228
Esophagus (C15) = 532
Stomach (C16) = 1,114
Colorectal (C18-21) = 6,968
Liver (C22) = 517
Gallbladder (C23-24) = 374
Pancreas (C25) = 1,412
Lung (C33-34) = 4,357
Breast (C50) = 16,015
Cervix (C53) = 1,565
Corpus uteri (C54) = 2,069
Ovary (C56-57) = 1,655
Prostate (C61) = 7,386
Total cancers (C00-C97) excluding non-melanoma skin cancer = NA

Cardiovascular endpoints
Acute coronary events = NA
Stroke = NA

Other endpoints
Type II diabetes (E11) = 12403

 

Please refer to the Documents section to access the number of incident cases for selected ICD-10 codes.

Documents

Datasets

NameDescription
EPIC

Exposure data collected at baseline in the...