Date of filling in this questionnaire or last update: 21/04/2021
Cohort name
  Cancer Prevention Study-II

  • United States

Please provide any other information on the cohort location/s if needed
  Recruitment in all 50 US States
  Alpa Patel
  American Cancer Society
Personal website
Do you want to add another Principal Investigator of the Cohort

  • Add another Principal Investigator of the cohort

  Marji McCullough
  American Cancer Society
Personal website
  Ryan Diver
  American Cancer Society
Personal website


Name of committee
  Emory University Institutional Review Board
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Or provide website


Data access policy (briefly describe)
Main aim of cohort, please briefly describe the main objectives of the cohort
  Identify factors associated with cancer risk and death in an adult US population recruited in 1982
Study design (please select as many as appropriate)

  • Prospective cohort

Source population (please select as many as appropriate)

  • General population: National

Comparators (please select as many as appropriate)

  • Internal study population

Inclusion criteria
  Over 30 years of age
Age range at entry (main cohort)

Minimum Maximum Mean
30 100+ 57

Age range at entry (subcohort)

Minimum Maximum Mean Please describe
40 92 63 Nutrition Cohort: A sub-cohort of 184,194 participants in 21 states recruited in 1992/1993to capture cancer incidence and have regular follow-up surveys
49 96 70 Lifelink Cohort: A sub-cohort of 39,200 participants who were recruited to provide a blood sample in 1998-2000

Men at enrollment
Women at enrollment
Children (<18 years) at enrollment
Men at last follow-up
Women at last follow-up
Children (<18 years) at last follow-up
  The CPS-II cohort of ~1.2 million participants begun in 1982 is followed only for mortality, and had no additional updated survey information.
The Nutrition sub-cohort of ~184,000 participants begun in 1992 is followed for cancer incidence and mortality. Additional surveys were administered every 2-years from 1997-2017.
The Lifelink sub-cohort of ~39,000 collect a survey and blood sample between 1998-2000. An additional ~70,000 participants provided a mouthwash sample in 2001.
Type of data for outcome follow-up (please select as many as appropriate)

  • Active (contact with participants)
  • Death certificate
  • Hospital / physician diagnoses
  • Use of registers (specify)

Active (contact with participants) (specify)

  • Volunteers confirmed vital status through 1988.

Death certificate (specify)

  • US National Death Index was used to collect fatal outcomes beginning in 1988 to present.

Hospital / Physician diagnoses (specify)

  • Subjects in the Nutrition sub-cohort self-report cancers which are then verified by medical records

Specify: Use of registers

  • Subjects in the Nutrition sub-cohort that self-report cancers but can not be verified by medical record are sent to their state cancer registry for verification

First follow-up period (provide year)
Last follow-up period (provide year)
Number of follow-ups after baseline (provide number)
  All 1.2 million subjects are followed for mortality outcomes.
Only the 184,000 subjects in the Nutrition cohort are followed for cancer incidence and sent additional surveys. Follow-ups and participation rates provided reference the Nutrition Cohort population only.
Source of exposure data collected (please select as many as appropriate)

  • Questionnaire, Personal (Self-reporting or interview)
  • Other (specify)

Specify: Other
  Blood samples
Occupational history/time frame
  Other (specify)
Specify: Other
  Current occupation and longest occupation at enrollment
Occupational coding performed
Occupation (specify coding system used)

  • Broad occupation groupings from 1980 US Census

Industry (specify coding system used)

  • None.

Types of exposure measurements

  • Biomarkers (see also section 5)

Methods for exposure assessment (please select as many as appropriate)

  • GIS (other spatial methods)
  • Self-report

Main categories

  • Dusts and fibres
  • Solvents
  • Pesticides
  • Other chemicals
  • Physical agents

Dusts and fibres | Fibres

  • Asbestos (any form of asbestos chrysotile, crocidolite, tremolite, anthophyllite, etc. or asbestos-containing material)

Dusts and fibres | Inorganic dusts

  • Coal dust
  • Stone (Natural or Artificial)

Dusts and fibres | Organic dusts

  • Textile dust
  • Wood dust (not specified)

Other chemicals | Engine exhaust

  • Diesel engine exhaust
  • Gasoline engine exhaust

Other chemicals | Polycyclic aromatic hydrocarbons (PAHs)

  • Asphalt/Bitumen fumes
  • Coal tar pitch

Other chemicals | Second hand tobacco smoke at work

  • Second hand tobacco smoke at work (Environmental tobacco smoke - ETS)

Other chemicals | Other

  • Other

Other chemicals | Other | Specify: Other
  Formaldehyde, Dyes
Physical agents

  • Radiation

  General occupational exposure grid: In your work or daily life, are (were) you regularly exposed to any of the following? Asbestos, Chemicals/Acids/Solvents, Coal or Stone Dusts, Coal Tar/Pitch/Asphalt, Diesel Engine Exhaust, Dyes, Formaldehyde, Gasoline Exhaust, Pesticides/Herbicides, Textile Fibers/Dusts, Wood Dust, X-rays\Radioactive Materials.
Baseline - type of outcome data collected (select more than one if applicable)

  • Questionnaire, individual (self-recording or interview)

Follow-up - type of outcome data collected (select more than one if applicable)

  • Death certificates
  • Medical records
  • Questionnaire, individual (self-recording or interview)
  • Registry-based


  • Cancer incidence
  • Mortality register

Outcome type (please select as many as appropriate)

  • Mortality

Diagnostic groups based on ICD10

  • C + D Neoplasms

C + D Neoplasms

  • Carcinoma in situ
  • Leukemia
  • Malignant neoplasms gastro intes. system including liver, gall bladder, pancreas
  • Malignant neoplasm lung
  • Mesothelioma
  • Other malignant neoplasm of respiratory and intrathoracic organs, heart, pleura
  • Malignant neoplasm of bone and articular cartilage
  • Melanoma and other malignant neoplasms of skin
  • Neoplasms connective and soft tissue including nerves
  • Malignant neoplasm of breast
  • Malignant neoplasms, females gynecological
  • Malignant neoplasms of male genital organs
  • Malignant neoplasm of urinary tract and kidney
  • Malignant neoplasms of eye, brain and other parts of central nervous system
  • Malignant neoplasms of thyroid and other endocrine glands
  • Malignant neoplasms of ill-defined, secondary and unspecified sites
  • Malignant neoplasm without specification of site including excl. leukemia

Other health related outcomes

  • Lifestyle change
  • Quality of life/wellbeing

  The entire 1982 cohort of 1.2 million is only followed for death since 1982. No additional outcomes.
The 1992 Nutrition sub-cohort is followed for cancer incidence and mortality. Additional health outcomes were self-reported on follow-up surveys.
Biological samples collected

  • Blood
  • Other

Specify: Other
  Mouthwash, Tumor tissue
Biological processing

  • DNA

Genetic and other lab analyses

  • Biomarkers (specify)
  • Genomics / GWAS
  • Metabolomics
  • Other (specify)

Specify: Biomarkers
  Bacterial and viral panels
Specify: Other
  Oral microbiome
  Biological samples are only available in the Lifelink Sub-cohort (blood samples) and the additional 70,000 subjects with mouthwash samples.
6. Other Information

  • Alcohol
  • Anthropometry
  • Demographics
  • Diet
  • Education
  • Environmental, air pollution
  • Medical history
  • Personality
  • Physical exercise
  • Residential history
  • Socioeconomic status
  • Smoking
  • Other (specify)

Specify: Other
  Reproductive history, family history of cancer
Possibility for linkage to data registries/data enrichment via data linkage

  • Medication usage

Please describe plans that are funded or most likely to be funded
  US Medicare data has been linked to the Nutrition sub-cohort. This contains the medications and diagnoses for the majority of participants over the age of 65.