Malmö Diet Cancer - MDC
In the early 1990s, the Swedish Cancer Foundation initiated a large cohort study with the primary goal of investigating the relationship between diet and subsequent cancer risk.
The study was led by Professor of Internal Medicine, Göran Berglund, and Professor of Epidemiology, Lars Janzon. Between 1991 and 1996, in all 17,000 women (born 1923-1950) and 11,000 men (born 1923-1945) were recruited, which corresponds to a participation rate of about 41 percent [2]. The recruitment is described in detail in several references. MDC is part of EPIC - The European Prospective Investigation into Diet and Cancer. This collaboration involves about 20 similar cohorts in ten European countries. In total, there are data and biological material from about 550,000 people. Now also extensive genetic materials (GWAS, exome sequencing) have become available through Professor Olle Melander.
Lifestyle, diet and samples
The baseline study consisted of a questionnaire that addressed lifestyle, socio-economic factors, medications and past illnesses. An important part of the baseline survey was dietary measurements. Participants were allowed to keep a diary for a week and write down what they ate, then supplemental individual interviews were conducted with each. The body constitution was examined in several ways; height, weight, hip and waist circumference were measured. Fat percentage was calculated using an impedance method. Finally, all blood samples that were separated and stored at minus 80° C or minus 140° C. DNA has been extracted from all individuals, and from 2020 all GWAS data is also available.
Early on, the study was extended with further questions. In a cardiovascular section (arm), approximately 6,000 men and women were examined [3]. Participants provided supplemental blood samples, this time fasting, and also examined carotid intimate media, the thickness of the neck vessels, using ultrasound technology. Another supplementary study was the bone density measurements performed on a large part of all participants. Finally, the so-called "Neck-Shoulder project" examined factors related to chronic pain and work conditions.
Re-examaniations and follow-ups
Five years after the baseline survey, all participants alive were asked to complete the questionnaire a second time. A total of just over 22,000 individuals responded to the form.
Between 2007 and 2012, a re-examination of the cardiovascular part (arm) was carried out [4]. More than 3,700 individuals participated. The re-examination consisted of a questionnaire, measurements of body constitution, blood pressure, glucose load (OGTT), ultrasound of carotid arteries and measurement of arterial stiffness, and blood sampling.
References
- Manjer J, Carlsson S, Elmståhl S, Gullberg B, Janzon L, Lindström M, Mattisson I, Berglund G. The Malmö Diet and Cancer Study: representativity, cancer incidence and mortality in participants and non-participants. Eur J Cancer Prev. 2001;10:489-99.
- Hedblad B, Nilsson P, Janzon L, Berglund G. Relation between insulin resistance and carotid intima-media thickness and stenosis in non-diabetic subjects. Results from a cross-sectional study in Malmö, Sweden. Diabet Med. 2000;17(4):299-307.
- Rosvall M, Persson M, Östling G, Nilsson PM, Melander O, Hedblad B, Engström G. Risk factors for the progression of carotid intima-media thickness over a 16-year follow-up period: the Malmö Diet and Cancer Study. Atherosclerosis. 2015; 239(2):615-21.
