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Cancer Prevention Study II (CPS-II)


The Cancer Prevention Study II (CPS-II), which began in 1982, is a prospective mortality study of approximately 1.2 million American men and women. Approximately 77,000 volunteers for the American Cancer Society recruited participants into the study in all 50 states, the District of Columbia, and Puerto Rico.

Each participant completed a four-page, confidential questionnaire. Baseline questions included personal identifiers, height, weight, demographic characteristics, personal and family history of cancer and other diseases, use of medicines and vitamins, menstrual and reproductive history (women), occupational exposures, dietary habits, alcohol and tobacco use, and various questions regarding exercise and behavior.

During the 24 years of completed mortality follow-up currently available for this cohort (1982-2006), 491,188 deaths have occurred; cause of death has been obtained for 99.3% of all deaths. Follow-up of CPS-II is expected to continue for many years to maximize the information obtained from this valuable study.

CPS-II Nutrition Survey

The CPS-II Nutrition Survey cohort was established in 1992 and 1993 as a subset of the larger CPS-II cohort with two primary objectives: 1) to obtain detailed information on dietary exposures and to update with additional exposure information, and 2) to conduct prospective cancer incidence follow-up in addition to mortality follow-up.

With these objectives in mind, staff again contacted close to half of the CPS-II population (men and women ages 50-74 in 21 states) in 1992 and 1993 and obtained updated information on nutrition and other cancer risk factors for 184,194 men and women. The 21 states participating in this survey were California, Connecticut, Florida, Georgia, Illinois, Iowa, Louisiana, Maryland, Massachusetts, Michigan, Minnesota, Missouri, New Mexico, New Jersey, New York, North Carolina, Pennsylvania, Utah, Virginia, Washington, and Wisconsin.

New questionnaires were sent to the CPS-II Nutrition Survey cohort in 1997, 1999, 2001, 2003, 2005, 2007, 2009, 2011, 2013, and 2015. These questionnaires updated information on exposures and also captured self-reported cancer incidence.

Ongoing cancer incidence follow-up for the CPS-II Nutrition Survey cohort is conducted by validating self-reported incidence cancers using medical records or linkage with state cancer registries. Nearly 30,000 incident cancers were reported in the interval 1992 to 2005. These data are used to examine the association of many factors (e.g., diet, lifestyle, and environment) with cancer incidence. Mortality follow-up of the entire CPS-II Nutrition Survey cohort will allow the study of the association between reported risk factors and survival. Initial findings include marked associations between obesity and aggressive forms of prostate cancer.

CPS-II Biorepository (addition of blood and cheek cell samples to CPS-II)

The Society has collected and archived blood samples from 40,000 participants and cheek cell samples (as a source of DNA) from 70,000 participants in the CPS-II Nutrition Survey cohort. The addition of archived biological specimens to the questionnaire information provided by the same individuals will provide a valuable long-term resource for examining many scientific questions, including how nutritional factors, hormones, and genetic susceptibility affect cancer risk. In separate collaborations with the Cancer Genetic Markers of Susceptibility (CGEMS) initiative and with the Breast and Prostate Cancer Cohort consortium (BPC3), inherited variations that increase the risk for breast and prostate cancer were recently described. Further analysis of other genetic information collected is ongoing.