The European Prospective Investigation into Cancer and Nutrition (EPIC) study is a

Europe Europe is a large peninsula conventionally considered a continent in its own right because of its great physical size and the weight of its history and traditions. Europe is also considered a subcontinent of Eurasia and it is located entirel ...

-wide prospective

cohort study A cohort study is a particular form of longitudinal study that samples a cohort (a group of people who share a defining characteristic, typically those who experienced a common event in a selected period, such as birth or graduation), performing ...

of the relationships between

diet Diet may refer to: Food * Diet (nutrition), the sum of the food consumed by an organism or group * Dieting, the deliberate selection of food to control body weight or nutrient intake ** Diet food, foods that aid in creating a diet for weight loss ...

and

cancer Cancer is a group of diseases involving abnormal cell growth with the potential to invade or spread to other parts of the body. These contrast with benign tumors, which do not spread. Possible signs and symptoms include a lump, abnormal b ...

, 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 The International Agency for Research on Cancer (IARC; french: Centre International de Recherche sur le Cancer, CIRC) is an intergovernmental agency forming part of the World Health Organization of the United Nations. Its role is to conduct and ...

(IARC), part of the

World Health Organization The World Health Organization (WHO) is a specialized agency of the United Nations responsible for international public health. The WHO Constitution states its main objective as "the attainment by all peoples of the highest possible level of ...

, and funded by the "Europe Against Cancer" programme of the

European Commission The European Commission (EC) is the executive of the European Union (EU). It operates as a cabinet government, with 27 members of the Commission (informally known as "Commissioners") headed by a President. It includes an administrative body ...

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 ) , song = ( en, "King Christian stood by the lofty mast") , song_type = National and royal anthem , image_map = EU-Denmark.svg , map_caption = , subdivision_type = Sovereign state , subdivision_name = Kingdom of Denmark , establish ...

(11%),

France France (), officially the French Republic ( ), is a country primarily located in Western Europe. It also comprises of overseas regions and territories in the Americas and the Atlantic, Pacific and Indian Oceans. Its metropolitan area ...

(14%),

Germany Germany,, officially the Federal Republic of Germany, is a country in Central Europe. It is the second most populous country in Europe after Russia, and the most populous member state of the European Union. Germany is situated betwe ...

(10%),

Greece Greece,, or , romanized: ', officially the Hellenic Republic, is a country in Southeast Europe. It is situated on the southern tip of the Balkans, and is located at the crossroads of Europe, Asia, and Africa. Greece shares land borders ...

(5%),

Italy Italy ( it, Italia ), officially the Italian Republic, ) or the Republic of Italy, is a country in Southern Europe. It is located in the middle of the Mediterranean Sea, and its territory largely coincides with the homonymous geographical ...

(9%),

The Netherlands ) , anthem = ( en, "William of Nassau") , image_map = , map_caption = , subdivision_type = Sovereign state , subdivision_name = Kingdom of the Netherlands , established_title = Before independence , established_date = Spanish Netherl ...

(8%),

Norway Norway, officially the Kingdom of Norway, is a Nordic country in Northern Europe, the mainland territory of which comprises the western and northernmost portion of the Scandinavian Peninsula. The remote Arctic island of Jan Mayen and the ...

(7%),

Spain , image_flag = Bandera de España.svg , image_coat = Escudo de España (mazonado).svg , national_motto = ''Plus ultra'' (Latin)(English: "Further Beyond") , national_anthem = (English: "Royal March") , i ...

(8%), Sweden (10%) and the

United Kingdom The United Kingdom of Great Britain and Northern Ireland, commonly known as the United Kingdom (UK) or Britain, is a country in Europe, off the north-western coast of the European mainland, continental mainland. It comprises England, Scotlan ...

(17%). One UK centre (Oxford) recruited 27,000

vegetarian Vegetarianism is the practice of abstaining from the consumption of meat (red meat, poultry, seafood, insects, and the flesh of any other animal). It may also include abstaining from eating all by-products of animal slaughter. Vegetariani ...

s and

vegan Veganism is the practice of abstaining from the use of animal product—particularly in diet—and an associated philosophy that rejects the commodity status of animals. An individual who follows the diet or philosophy is known as a vegan. ...

s; 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 A questionnaire is a research instrument that consists of a set of questions (or other types of prompts) for the purpose of gathering information from respondents through survey or statistical study. A research questionnaire is typically a mix of ...

s (self-administered or interview-based), seven-day food diaries, blood samples and

anthropometric Anthropometry () refers to the measurement of the human individual. An early tool of physical anthropology, it has been used for identification, for the purposes of understanding human physical variation, in paleoanthropology and in various atte ...

measurements, such as body mass index and waist-to-hip ratio. Additionally, the GenAir case-control study is studying the relationship of

passive smoking Passive smoking is the inhalation of tobacco smoke, called secondhand smoke (SHS), or environmental tobacco smoke (ETS), by persons other than the intended "active" smoker. It occurs when tobacco smoke enters an environment, causing its inhalat ...

and

air pollution Air pollution is the contamination of air due to the presence of substances in the atmosphere that are harmful to the health of humans and other living beings, or cause damage to the climate or to materials. There are many different typ ...

with cancers and

respiratory disease Respiratory diseases, or lung diseases, are pathological conditions affecting the organs and tissues that make gas exchange difficult in air-breathing animals. They include conditions of the respiratory tract including the trachea, bronchi, bro ...

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 The stomach is a muscular, hollow organ in the gastrointestinal tract of humans and many other animals, including several invertebrates. The stomach has a dilated structure and functions as a vital organ in the digestive system. The stomach i ...

, colorectal,

breast The breast is one of two prominences located on the upper ventral region of a primate's torso. Both females and males develop breasts from the same embryological tissues. In females, it serves as the mammary gland, which produces and sec ...

prostate The prostate is both an accessory gland of the male reproductive system and a muscle-driven mechanical switch between urination and ejaculation. It is found only in some mammals. It differs between species anatomically, chemically, and phys ...

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 A hormone (from the Greek participle , "setting in motion") is a class of signaling molecules in multicellular organisms that are sent to distant organs by complex biological processes to regulate physiology and behavior. Hormones are require ...

s and hormone-like factors.

Key findings

The study and its analysis is ongoing, bu
key results
of the study retrieved in 2008 are: *Lowered sodium from

salt Salt is a mineral composed primarily of sodium chloride (NaCl), a chemical compound belonging to the larger class of salts; salt in the form of a natural crystalline mineral is known as rock salt or halite. Salt is present in vast quant ...

intake, high potassium from

fruit In botany, a fruit is the seed-bearing structure in flowering plants that is formed from the ovary after flowering. Fruits are the means by which flowering plants (also known as angiosperms) disseminate their seeds. Edible fruits in particu ...

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 Dietary fiber (in British English fibre) or roughage is the portion of plant-derived food that cannot be completely broken down by human digestive enzymes. Dietary fibers are diverse in chemical composition, and can be grouped generally by th ...

protects against

bowel cancer Colorectal cancer (CRC), also known as bowel cancer, colon cancer, or rectal cancer, is the development of cancer from the colon or rectum (parts of the large intestine). Signs and symptoms may include blood in the stool, a change in bowel m ...

*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) Subsequent findings from 2012 and 2013 are: *Dietary flavonoid intake is

associated Associated may refer to: *Associated, former name of Avon, Contra Costa County, California * Associated Hebrew Schools of Toronto, a school in Canada *Associated Newspapers, former name of DMG Media, a British publishing company See also *Associati ...

with reduced

gastric carcinoma Stomach cancer, also known as gastric cancer, is a cancer that develops from the lining of the stomach. Most cases of stomach cancers are gastric carcinomas, which can be divided into a number of subtypes, including gastric adenocarcinomas. Lym ...

risk in women but not men *Regular consumption of

processed meat Processed meat is considered to be any meat which has been modified in order to either improve its taste or to extend its shelf life. Methods of meat processing include salting, curing, fermentation, smoking, and/or the addition of chemical pr ...

increases the risk of cardiovascular diseases and death from cancer Subsequent findings from 2021 are: * Dietary factors associated with reduced cancer mortality included raw vegetable intake; dietary fiber intake; the Mediterranean diet; other diet patterns included low meat eaters, vegetarians/vegans, or fish eaters.

Notes

Selected papers

Review * Primary * * * * * * * * *{{cite journal , vauthors=Verheus M, Peeters PH, Rinaldi S, etal , title=Serum C-peptide levels and breast cancer risk: results from the European Prospective Investigation into Cancer and Nutrition (EPIC) , journal=Int. J. Cancer , volume=119 , issue=3 , pages=659–67 , date=August 2006 , pmid=16572422 , doi=10.1002/ijc.21861, hdl=1874/19269 , s2cid=25233808 , hdl-access=free

External links

EPIC project (IARC)EPIC study (CR UK)EPIC (Oxford centre)
(preferentially recruited vegetarians & vegans)
EPIC-Norfolk (UK Norfolk cohort)
Epidemiological study projects Nutritional science Oncology