150,000 men from 8 European countries
Nearly 8,000 incident cases of prostate cancer
EPIC Prostate is a programme of prospective analyses designed to investigate factors related to the development of prostate cancer, with a particular emphasis on identifying modifiable risk factors for aggressive disease. The studies are based on 150,000 men from eight European countries who are participating in the EPIC cohort. Current analyses include 7,000 incident cases of prostate cancer.
Prostate cancer is the commonest cancer among men in Europe and North America, yet there are no known modifiable risk factors to inform prevention. Through a co-ordinated programme of analyses we aim to advance understanding of the aetiology of aggressive prostate cancer and provide the reliable data needed for the development of evidence-based strategies for prostate cancer prevention.
The EPIC-Prostate study is one of the largest prospective studies of prostate cancer in the world with extensive phenotypic data, blood samples, genetic data and ~3 million person years of follow-up. Participants were recruited between 1992 and 2000, so that average follow-up is now approaching 20 years and there will soon be over 8,000 incident cases of prostate cancer. Over the next five years, we will use recent developments in high-throughput technologies to provide detailed information on novel biomarkers and metabolic profiles, combined with the wealth of data already collected and with detailed data on tumour phenotype, to examine a wide range of molecular and clinical factors that may influence the development of high risk prostate cancer.
Previous EPIC prostate cancer analyses have suggested that men with higher adiposity may have a higher risk of aggressive prostate cancer and we are looking into the mechanisms underlying this possible relationship. Other analyses in EPIC-Prostate have shown that few aspects of lifestyle or diet are strongly related to total prostate cancer risk; overall in EPIC prostate cancer risk is not clearly related to alcohol, smoking, or physical activity. We also showed that higher plasma concentrations of microseminoprotein-beta (MSP) are inversely associated with risk of total, advanced and fatal prostate cancer, and results from our Mendelian randomisation analyses implied that this relationship is causal.
Studies of blood biomarkers in EPIC have examined a range of hormones, growth factors and nutritional biomarkers in relation to prostate cancer risk and subsequently these data have been combined with all the other data available in our international biomarker consortium (The Endogenous Hormones, Nutritional Biomarkers and Prostate Cancer Collaborative Group). We have found a strong positive relationship between blood levels of the growth factor insulin-like growth factor-1 and prostate cancer risk and have shown for the first time that men with very low free testosterone have a lower risk for prostate cancer, but possible an increase in risk for high grade disease.