Abstract
BackgroundProspective cohorts represent an essential design for epidemiological studies and allow for the study of the combined effects of lifestyle, environment, genetic predisposition, and other risk factors on a large variety of disease endpoints. The CONSTANCES cohort is intended to provide public health information and to serve as an "open epidemiologic laboratory" accessible to the epidemiologic research community. Although designed as a "general-purpose" cohort with very broad coverage, it will particularly focus on occupational and social determinants of health, and on aging.Methods/DesignThe CONSTANCES cohort is designed as a randomly selected representative sample of French adults aged 18-69 years at inception; 200,000 subjects will be included over a five-year period. At inclusion, the selected subjects will be invited to fill a questionnaire and to attend a Health Screening Center (HSC) for a comprehensive health examination: weight, height, blood pressure, electrocardiogram, vision, auditory, spirometry, and biological parameters; for those aged 45 years and older, a specific work-up of functional, physical, and cognitive capacities will be performed. A biobank will be set up. The follow-up includes a yearly self-administered questionnaire, and a periodic visit to an HSC. Social and work-related events and health data will be collected from the French national retirement, health and death databases. The data that will be collected include social and demographic characteristics, socioeconomic status, life events, behaviors, and occupational factors. The health data will cover a wide spectrum: self-reported health scales, reported prevalent and incident diseases, long-term chronic diseases and hospitalizations, sick-leaves, handicaps, limitations, disabilities and injuries, healthcare utilization and services provided, and causes of death.To take into account non-participation at inclusion and attrition throughout the longitudinal follow-up, a cohort of non-participants will be set up and followed through the same national databases as participants.A field-pilot was performed in 2010 in seven HSCs, which included about 3,500 subjects; it showed a satisfactory structure of the sample and a good validity of the collected data.DiscussionThe constitution of the full eligible sample is planned during the last trimester of 2010, and the cohort will be launched at the beginning of 2011.
Highlights
Prospective cohorts represent an essential design for epidemiological studies and allow for the study of the combined effects of lifestyle, environment, genetic predisposition, and other risk factors on a large variety of disease endpoints
Main objectives The objective of the CONSTANCES ("Cohorte des consultants des Centres d’examens de santé”) project is to set up a large population-based cohort to contribute to the development of epidemiologic research and to provide useful public health information
It is conducted in partnership with the National Health Insurance Fund administered by the Caisse nationale d’assurance maladie des travailleurs salaries (CNAMTS) [7], the principal health insurance fund in France, which covers more than 80% of the French population, and with the Ministry of Health and the National Institute of Health and Medical Research
Summary
Prospective cohorts represent an essential design for epidemiological studies and allow for the study of the combined effects of lifestyle, environment, genetic predisposition, and other risk factors on a large variety of disease endpoints. Main objectives The objective of the CONSTANCES ("Cohorte des consultants des Centres d’examens de santé”) project is to set up a large population-based cohort to contribute to the development of epidemiologic research and to provide useful public health information It is conducted in partnership with the National Health Insurance Fund administered by the Caisse nationale d’assurance maladie des travailleurs salaries (CNAMTS) [7], the principal health insurance fund in France, which covers more than 80% of the French population, and with the Ministry of Health and the National Institute of Health and Medical Research. The CONSTANCES cohort will be a large sample, representative of the general French population, and characterized by broad coverage of health problems and health determinants It will serve as an important scientific instrument, in a similar manner to a telescope or a particle accelerator, for example, or a genotyping laboratory with sequencers ― built not to answer a specific question but rather to help analyze a wide range of scientific problems. The design of CONSTANCES relied on the experience of the GAZEL Cohort Study, an open general-purpose prospective cohort established in 1989 by our research unit which is currently supporting more than 40 different nested research projects on very diverse scientific topics [8,9,10]
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