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Diet and cancer — the European Prospective Investigation into Cancer and Nutrition


Diet is thought to be one of the most important contributing factors to cancer risk. The contribution of diet to cancer is linked to genetic factors, and uncovering the details of this linkage requires that very large studies be carried out over long time periods, with a detailed analysis of food intake. For this reason, the European Prospective Investigation into Cancer and Nutrition — a study of over 500,000 people in 10 European countries — was devised, to investigate the relationship between diet, metabolic and genetic factors, and cancer. How will this study be run, and will it be able to avoid some of the problems of measurement error that were previously encountered with other dietary studies?

Key Points

  • Diet is thought to be one of the most important contributing factors to cancer risk, but is linked to metabolic and genetic factors.

  • The European Prospective Investigation into Cancer and Nutrition (EPIC) — a study of over 500,000 people in 10 European countries — was devised to investigate the relationship between diet, metabolic and genetic factors, and cancer.

  • In the EPIC study, food consumption has been measured by country-specific questionnaires that were designed to capture local dietary habits and to provide high compliance. At the time of enrolment, weight, height, lifestyle and personal history data were also collected, along with biological samples including plasma, serum, leukocytes and erythrocytes, from approximately 400,000 individuals, which have been stored in liquid nitrogen.

  • Over 9 million samples have been stored, making the EPIC centres, collectively, the largest biorepository in the world that is available for genetic, metabolic, biochemical and epidemiological data.

  • Subsets of the EPIC study, called 'The Eurogast project' and 'Genair', have been initiated to investigate correlations between tumour-associated genetic mutations, polymorphisms, diet and cancer.

  • EPIC study data are already available on the associations between dietary fibre intake and colorectal cancer, and between fat intake and breast cancer.

  • Large, prospective studies are the best way to study the interaction between diet and cancer.

  • Information on lifestyle and environmental exposure, especially of diet and biomarkers, can only be accurately determined by studying large populations over prolonged periods of time.

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The authors would like to acknowledge the following for support of the EPIC study: 'Europe Against Cancer' Programme of the European Commission (SANCO); Ligue contre le Cancer (France); Société 3M (France); Mutuelle Générale de l'Education Nationale; Institut National de la Santé et de la Recherche Médicale (INSERM); German Cancer Aid; German Cancer Research Center; German Federal Ministry of Education and Research; Danish Cancer Society; Health Research Fund (FIS) of the Spanish Ministry of Health; the participating regional governments and institutions of Spain; Cancer Research UK; Medical Research Council, UK; the Stroke Association, UK; British Heart Foundation; Department of Health, UK; Food Standards Agency, UK; the Wellcome Trust, UK; Greek Ministry of Health; Greek Ministry of Education; Italian Association for Research on Cancer; Italian National Research Council; Dutch Ministry of Public Health, Welfare and Sports; Dutch Ministry of Health; Dutch Prevention Funds; LK Research Funds; Dutch ZON (Zorg Onderzoek Nederland); World Cancer Research Fund; Swedish Cancer Society; Swedish Scientific Council; Regional Government of Skane, Sweden; Norwegian Cancer Society.

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Correspondence to Sheila Bingham.

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The authors declare no competing financial interests.

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A study in which the individuals are identified and then followed over time.

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Further reading

Figure 1: Colorectal cancer incidence in males in the European Union.
Figure 2: Thirty-year trends in colon cancer rates for the United Kingdom and Japan.
Figure 3: Association between fat intake and breast cancer.
Figure 4: Plasma lycopene concentrations in 16 regions of the European Prospective Investigation of Cancer study.
Figure 5: Colorectal cancer incidence and red-meat consumption worldwide in men.