1 Epidemiology in Groningen What is epidemiology Our department Projects in our department Special Oncology

2 Definition of epidemiology “The study of the distribution and determinants of health- related states or events in specified populations, and the application of this study to control of health problems” The study of the occurrence of a disease in a population, in relation to its determinants.

3 Epidemiology is occurrence research Object of research: occurrence relation Outcome = ƒ(determinants) –Determinants are all factors that influence the frequency of a disease (causal or not-causal) –Outcome may include (other) risk factors, disorders, disease progression/cure, burden of disease, costs

5 Department of Epidemiology at UMCG Facts Established February 2005 Union of epidemiology, data management and MTA groups from Medical School and Academic Hospital Focus on own research in collaboration with strong clinical research groups Clinical Research desk (CRD) for consultancy Teaching in several Bachelors and Master programs, including new MSc Epidemiology program About 65 people –8 associate/full professors –~25 scientific staff

7 Scientific output PubMed publications –27 first, second, last author 2 PhD-theses completed (co-promotor) 24 grant applications –≥ 5 granted

8 Organization Two sections –Research & Education R&E (O&O) Diabetes/obesity Cardio-renal disorders Lung diseases Oncology Psychiatry Medical statistics Genetic epidemiology MTA –Research support (RCC) Management team –Secretary, supporting staff

9 Department of Epidemiology Ongoing projects offering excellent research opportunities

10 Chronic diseases are the greatest threat to quality of life and have one thing in common: ageing is the number 1 risk factor Source: WHO, Global Burden of Disease Estimates 1)Disability Adjusted Life Year Diabetes Alzheimer’s Cancer Parkinson’s All diseases combined Communicable, hereditary and nutrition related diseases Age-related (chronic) diseases Burden through age-related diseases [worldwide loss in DALY’s 1), 2005 =100%] Index 2005

11 LIFELINES Focus on modification of universal risk factors for multifactorial diseases Population-based study participants from the northern provinces of the Netherlands Three-generation study design Multiple UMCG departments involved

12 Purpose of LifeLines Central question Why do some people get old in a healthy manner, and why have others already severe impairments or diseases early in their life? Focus on Multifactorial diseases (gene + environment) Factors which cause more than one disease

13 Main focus of LifeLines Frequently occuring diseases with high impact Cardio-renal disease Ageing Lung disease Metabolic disease Psychiatric disease Note: many diseases are defined by an arbitrary cut-off in a continuous disease marker or endophenotype.

14 LifeLines cohort dimensions The study will cover 30,000 index persons (probands or propositi) with an age between 25 and 50 years in a defined geographical area, and subsequently assess and follow their family members

15 Mental disease- TRAILS Aims at understanding the origins of mental disease Provides a multitude of repeatedly measured psychosocial and biological data Included a cohort of more than 2000 adolescents from the general population Principally carried out by the department of Psychiatry

16 Cardiovascular disease - PREVEND Directed at the assessment of the impact of microalbuminuria Focus is on renal and cardiovascular disease Cohort study with 8592 persons from the general population Carried out in close collaboration with the department of Internal Medicine

17 Adiposity - GECKO Focus on development of body weight during the first year of life Measures of metabolism, genetics, parental life style Includes a cohort of all children born in Drenthe during one year (N=5500) Carried out in close collaboration with the department of Pediatrics gecko

18 COPD - VLAGTWEDDE/VLAARDINGEN Sample of the general population of the Netherlands followed up for 25 years Measurements of FEV1, single nucleotide polymorphisms, life style factors (smoking) In collaboration with the department of Pulmonary Diseases

19 Oncology – CANCER REGISTRY Early detection of breast and ovarian cancer in families with BRCA mutations Follow-up after breast cancer Incidence and determinants of irradical tumor resection