The Malmö Diet and Cancer Study joined EPIC in 1993 and the Västerbotten County project (Northern Sweden Health and Disease Study Cohort, based in Umeå) joined EPIC in 1996/1997 as associated projects.

Malmö: The Malmö Diet and Cancer Study recruited a total of 28,098 subjects between 1991 and 1996 and became associated with EPIC in 1993. Men aged 46 to 73 years and women aged 45 to 73 years were invited to participate in the study. Information on diet was obtained through a modified diet history methodology. Lifestyle, socio-economic and medical history information was obtained using a self-administered questionnaire. Measurements of height, weight, blood pressure and body composition (through a bioimpedance methodology) were assessed at a physical examination. A versatile biobanks with erythrocytes, granulocytes and cryopreserved alive lymphocytes has been created. A DNA-extraction has been performed in all participants. All former participants were sent a slightly modified questionnaire 5-years after baseline examination, and about 22.000 individuals returned completed questionnaires. As part of the baseline examination, about 6000 men and women took part in additional investigations directed towards identification of risk factors for cardiovascular disease. This sub-cohort, The MDCS-CV, is currently re-examined including the same components as the baseline examination.

Umeå: The collaborative research agreement with EPIC is made with the Northern Sweden Health and Disease Study (NSHDS) which consists of blood samples and questionnaires collected from the Västerbotten Intervention program (VIP), the Northern Sweden MONICA project and the Västerbotten Mammary Screening Program. Originally VIP is a long-term project intended for health promotion of the population of Västerbotten. Since 1985 all individuals 40, 50 and 60 years of age in the population of the county are invited for screening and the cohort included by April 2007 99 000 sampling occasions from 77 000 unique individuals. From 1995 a second blood sample (and questionnaire) is taken with a 10-year interval of the individuals within the cohort. The VIP material is since 1995 supplemented with blood samples and questionnaires from the mammary screening program (29 000 unique individuals and 54 500 sampling occasions). From 1997 repeated screening was started within the mammary screening program with sampling every second year in the age group 50-69 years within the county. The Northern Sweden MONICA Project (screening 1986, 1990, 1994, 1999 and 2004) includes 8 900 unique individuals with 14 200 sampling occasions. Repeated sampling was performed in the MONICA project in 1999 on individuals participating in –86, -90, and –94. The total NSHDS cohort contains in April 2007 93 000 unique individuals with 168 000 sampling occasions. Life style and environmental information is collected from the subjects of the VIP and MONICA cohorts. In the Mammary Screening Cohort a questionnaire with questions on hormonal status is collected.
Blood samples are taken within the NSHDS cohorts in a uniform way. Every blood sample is dispersed and then stored in -80° C freezers. Each tube (one heparin and one EDTA) is divided into three plasma aliquots (1,5 ml each), one buffy coat (500ul) and one erythrocyte aliquot (1,5 ml), which gives totally 10 aliquots from each sampling occasion.

For some specific project the full VIP cohort is used within EPIC, otherwise the recruitment years 1992 – 1996 are used.

Follow-up aimed at identifying new cancer cases and deaths is based on national and local registries. By the end of 2008, 5704 incident cancer events had been diagnosed and over 3858 former participants had died in the MDCS. Corresponding number for Umeå was xxx incident cancer events and xxx deaths.