THE EPIC PROJECT - RATIONALE AND STUDY DESIGN

Background. The most consistent result of epidemiological studies on d iet and cancer is that a diet rich in vegetables, fruit and, more gene rally, in plant foods is associated with a reduced risk of cancer at s everal anatomical sites, Epidemiological studies have been less consis tent regarding the putative increase in risk related to consumption of fat or meat. in addition it has not been possible to identify clearly the biological role of specific nutrients or non-nutrient food compon ents in the prevention or causation of cancer. Limitations in the prec ision and validity of traditional dietary intake measurements and limi ted use of biomarkers combined with narrow ranges of variations in die tary habits within single populations, have been the main reasons for the limited success in identifying more specific diet and cancer links . Methods. EPIC is a multi-centre prospective cohort study designed to investigate the relation between diet, nutritional and metabolic char acteristics, various lifestyle factors and the risk of cancer. The stu dy is based in 22 collaborating centres in nine European countries and includes populations characterized by large variations in dietary hab its and cancer risk. Data are collected on diet, physical activity, se xual maturation and reproductive history, lifetime consumption of alco hol and tobacco, previous and current illnesses and current medication . Following a common protocol and using identical equipment, blood sam ples are collected, aliquoted into plasma, serum, white blood cells an d erythrocytes, and stored in liquid nitrogen at -196 degrees C for fu ture laboratory analyses on cancer cases and matched healthy controls. Anthropometric measurements are taken according to a standard protoco l. It is planned to include around 400 000 middle-aged men and women. Results and conclusions, The collection of questionnaire data, anthrop ometric measurements and blood samples is underway, Almost 340 000 sub jects had been included in the study by mid-1996, and recruitment is e xpected to be almost complete by 1997. Follow-up for cancer incidence and total mortality has started and it is expected that about 23 000 c ancer cases will be identified during the first 10 years of follow-up.