What is Health 2020?
Health 2020 is a prospective cohort study first started by Cancer Council Victoria in 1990. It was the flagship research platform for the newly formed Cancer Epidemiology Centre at Cancer Council Victoria.
When Health 2020 was conceived, its design was shaped by research that showed that post-World War II migrants from Southern Europe were less likely to be affected by certain cancers. We wanted to see whether this might be due to aspects of their diet and lifestyle, which were notably different to those Australians of British descent. Health 2020 actively recruited migrants from Southern European migrant communities; nearly a quarter of Health 2020 participants were born in Italy or Greece.
Thus, Health 2020 was designed to investigate the roles of diet and lifestyle in causing cancer and other non-communicable diseases. At the time, diet and nutrition were considered important to cancer causation but there was little detailed information that would be adequate to inform prevention.
To this end we composed a series of questionnaires, with a strong focus on the influence of individual foods and food groups, macronutrients (fats, carbohydrates and proteins) and micronutrients (vitamins and minerals) on the risk of cancer. We also stored blood samples, to enable the analysis of dietary markers detectable in the blood. To enable research on heart disease and diabetes as well as cancer, we also took direct physical and clinical measurements of all participants (height, weight, blood pressure, heart rate).
As we addressed our research questions over time, we adapted our data collection at each follow-up to refine our approach and better answer remaining questions. We also repeated blood sampling and physical measurements to be able to assess any effect of changes over time.
What we did not anticipate at the start of the study was the rapid growth in genomic technology and knowledge. Health 2020 blood samples, which we originally collected solely to measure dietary and other markers, became a highly valuable source of DNA to examine genetic risk factors for disease. This field of research has been our principal focus for the past 15 years.
What we found
Health 2020 has so far produced over 900 scientific publications. The most influential results have come from combining data with other cohort studies in international consortia. Examples include the finding that overweight and obesity are associated with increased risk of many cancers as well as death from any cause; and the identification of common genetic variants (variations in the DNA sequence along our chromosomes) associated with risk of breast, bowel, prostate and pancreatic cancer.
Further details of the study and its findings are provided in this publication.
Health 2020 continues to be a valuable resource; some of our current work focusses on alcohol and other risk factors for stomach cancer, biological mechanisms underlying the effect of obesity on post-menopausal breast cancer, and developing better risk prediction models for breast cancer. The addition of data from our next large cohort study, the ABC Study, will help us continue producing significant research results.
Milne RL et al. Cohort Profile: The Melbourne Collaborative Cohort Study (Health 2020). Int J Epidemiol. 2017 Dec 1;46(6):1757-1757i.
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