The Asia Cohort Consortium is led by Manami Inoue, MD PhD, Chair, Division of Prevention, National Cancer Center Institute for Cancer Control, Tokyo, Japan. The ACC Coordinating Center was established at the Fred Hutchinson Cancer Research Center to provide support for scientific collaboration, coordination and communication, data operations, and statistical consultation and has since moved to the National Cancer Center Japan.

Investigators from Bangladesh, China, India, Iran, Japan, Korea, Malaysia, Mongolia, Singapore, Taiwan, the United States, and other countries meet on a biannual basis to report on the progress of each country's cohort, to discuss issues relevant to the development of common protocol guidelines, and to prepare for collaborative projects. Working groups, each consisting of representatives from the different member countries, have been established to examine specifically the issues of: diet; obesity and physical activity; occupation and environment; alcohol and tobacco; and medical and reproductive history.

Rationale

The Asia Cohort Consortium (ACC) seeks to understand the relationship between genetics, environmental exposures, and the etiology of disease through the establishment of a cohort, or population laboratory, of at least 1 million healthy people around the world who will be followed over time to various disease endpoints, including cancer.

The concept of a population laboratory involves not just a population cohort but the capacity and intention to develop markers of early disease and to follow cohort members through diagnosis and treatment to outcome.* Some informative relationships that can be explored using the population laboratory include the association of exposure with disease; genome variability with disease; gene-environment interaction with molecularly defined disease; marker sets (e.g. plasma-protein profile) with early detection of molecularly defined disease; and genome, treatment and molecularly defined disease with outcome.

Accordingly, what is needed involves not just measurement of genetic variation but also variation in environmental exposures. The ACC addresses the scientific need to establish the complete pattern of susceptibility and resistance to disease, to identify disease more finely, and to establish which protein patterns provide the signal for disease, by recruiting and tracking a large number of individuals from diverse settings who are well characterized genetically, whose behavioral and environmental characteristics are well mapped, and whose illness pattern and mortality can be monitored. One of the things that we have learned over the last 5 years is that much of the genetic variation that is associated with disease risk is relevant only in the presence of environmental variability.

Collaboration

Currently, Consortium members who are also principal investigators of previously established cohorts are collaborating on multiple epidemiological studies focused on various risk factors and and health outcomes in Asian populations. The scientific objectives of these projects are to assess the association of BMI, diet, environmental and other risk factors and disease incidence, total and cause-specific mortality, and the role of a number of confounders. The ACC has over 40 on-going projects.

New cohorts, as part of the Consortium, were funded and began operating in Korea, Malaysia, Singapore, and Taiwan. Other countries are in the development stages for their cohorts. Instruments and protocols among Consortium members are shared via a password-accessible website, and discussion among working group members also takes place through occasional separate meetings and communications.

* Potter JD. Epidemiology informing clinical practice: from bills of mortality to population laboratories. Nature Clinical Practice Oncology. 2(12):625-34, 2005 Dec.