Abstract
The German National Cohort (GNC) is a joint interdisciplinary endeavour of scientists from the Helmholtz and the Leibniz Association, universities, and other research institutes. Its aim is to investigate the causes for the development of major chronic diseases, i.e. cardiovascular diseases, cancer, diabetes, neurodegenerative/-psychiatric diseases, musculoskeletal diseases, respiratory and infectious diseases, and their pre-clinical stages or functional health impairments. Across Germany, a random sample of the general population will be drawn by 18 regional study centres, including a total of 100,000 women and 100,000 men aged 20–69 years. The baseline assessments include an extensive interview and self-completion questionnaires, a wide range of medical examinations and the collection of various biomaterials. In a random subgroup of 20 % of the participants (n = 40,000) an intensified examination (“Level 2”) programme will be performed. In addition, in five of the 18 study centres a total of 30,000 study participants will take part in a magnetic resonance imaging examination programme, and all of these participants will also be offered the intensified Level 2 examinations. After 4–5 years, all participants will be invited for a re-assessment. Information about chronic disease endpoints will be collected through a combination of active follow-up (including questionnaires every 2–3 years) and record linkages. The GNC is planned for an overall duration of 25–30 years. It will provide a major, central resource for population-based epidemiology in Germany, and will help to identify new and tailored strategies for early detection, prediction, and primary prevention of major diseases.
Highlights
Over the last 30 years, life expectancy has continuously improved, in part explained by a downwards trend in incidence rates of cardiovascular diseases and by improved clinical care for cardiovascular and other chronic diseases
The German National Cohort (GNC) will provide a central platform for future epidemiological research in Germany, with a strong potential to push the development of new strategies for prevention, early detection and prognosis of major chronic diseases
With its broad spectrum of examinations and the systematic re-assessments of all study participants, and its broad spectrum of high-quality biomaterials a cohort of this size provides an excellent tool for future, population-based longitudinal research
Summary
Over the last 30 years, life expectancy has continuously improved, in part explained by a downwards trend in incidence rates of cardiovascular diseases and by improved clinical care for cardiovascular and other chronic diseases. Population-based prospective cohorts provide the ideal design for research on the combined effects of lifestyle, occupation and environment, social and psychosocial factors and genetic predisposition on disease development. The repeated collection of biomaterials in combination with extensive information from questionnaires and medical examinations is a basic asset of its design The combination of these sources of information—repeated over time—will make it possible to address pathways of disease development, providing clues to the biological mechanisms that may explain observed relationships. The National Cohort will provide an outstanding resource for studies aiming to develop and/or validate comprehensive risk models that integrate risk factor information obtained by questionnaires, clinical examinations, whole-body magnetic resonance imaging (MRI), and the assessment of genetic and other biological markers in blood, urine and other bio-specimens (Table 3). The bio-specimen repository of the GNC will provide a valuable resource for the discovery and validation of novel biomarkers for early disease detection, at the same time ensuring a rapid connection between basic discovery research and its confirmation and validation in appropriately designed human population studies
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