The European Prospective Investigation into Cancer and Nutrition (EPIC-Europe) is a long-term, large-scale collaborative project that studies different populations from countries across Europe to investigate the relationships between diet, nutrition, lifestyle and environmental factors and the incidence of cancer and other chronic diseases. It is one of the largest cohort studies in the world, with more than half a million participants recruited across 10 countries in western Europe. EPIC-Europe was launched in the 1990s and has been going on for more than 30 years.
Participants were recruited to the study from 10 Western European countries with geographical breadth as well as diversity in dietary and lifestyle habits and disease patterns. Information on the design, the study population, the participating centres, the collected data, and available resources are detailed in Riboli et al. (2002) (PMID:12639222). Upon recruitment, participants provided blood samples, had their body size and shape measured, and completed detailed dietary and lifestyle questionnaires, including smoking, alcohol consumption, medical history, physical activity, and other habits. Since then, lifestyle and dietary assessments have been collected during follow-up to investigate exposure changes, as detailed in this table. The incidence of cancer and other diseases, as well as information on mortality, was also collected during follow-up, as detailed here. The tracking of a large spectrum of participants’ lifestyle exposures, cancer, other diseases, and mortality enabled key associations to be assessed.
EPIC-Europe is a prospective study, in which information is collected at recruitment, before participants develop disease, enabling researchers to gather data along the way and gain unique insights into why some participants become ill and others do not. Information gained from the analysis of participants’ blood samples provides greater insight into how cancers at different anatomical sites can develop and how they may be identified earlier, when the chances of longer-term survival and potentially curative treatments are likely to be highest.
Although many similar prospective cohort studies have been undertaken, the key strength of EPIC-Europe lies in its size, its scope, and the collection of detailed exposure information and biospecimens, which are stored in biobanks at IARC and local centres. With more than half a million participants and data collected over a period of 25 years, EPIC-Europe has accumulated a large number of incident cancer cases and deaths. The study is therefore able to investigate a wide range of hypotheses on the role of foods, dietary patterns, nutrition, and other lifestyle habits on the development of cancer and other major chronic diseases. Other continuing studies that are linked directly to the cohort and rely on its data are the EPIC InterAct Project, which assesses risk factors for type-2 diabetes, and the EPIC CVD Project, which assesses risk factors for cardiovascular diseases.
The EPIC-Europe Steering Committee oversees the EPIC-Europe study. It is made up of all EPIC-Europe principal investigators, plus a Chairperson chosen by the Steering Committee. Decisions are usually made by consensus.
The EPIC-Europe Steering Committee holds regular meetings, once a month by teleconference and once a year in person. Meeting minutes keep track of what is discussed and decided, including the approval of new research projects and decisions on how to use EPIC-Europe resources.
The scientific research that takes place within EPIC-Europe is organized into Working Groups, which cover the main areas of research. New ideas for scientific projects are first discussed within the relevant Working Group and then submitted to the EPIC-Europe Steering Committee for review and approval.
Analysis of EPIC-Europe data has resulted in the publication of more than 3000 scientific papers revealing important associations between environmental, dietary, and lifestyle factors and the development of cancer. Scientists conceptualize, plan, and implement their collaborative projects within working groups, with one for each major anatomical site of cancer.
The EPIC-Europe cohort has stimulated considerable scientific research, growth, and activity in each of the participating countries. EPIC-Europe data and biospecimens are used by a diverse network of researchers and scientists using state-of-the-art analytical and laboratory methodologies to address key questions and knowledge gaps on risk factors and underlying mechanisms of cancer development.
The evidence produced by the EPIC-Europe study also equips governments and public health officials with the knowledge they need to implement actions and make recommendations geared toward the prevention of cancer and other chronic diseases.
Findings from EPIC-Europe are also widely available to the public, informing them about healthy dietary and lifestyle modifications that people can make in their daily habits for cancer prevention.
The EPIC-Europe study is jointly coordinated by Professor Elio Riboli and Professor Marc Gunter at Imperial College London, United Kingdom, and Dr Pietro Ferrari and Dr Paul Brennan at the International Agency for Research on Cancer in Lyon, France.