Swedish Mammography Cohort

The questionnaire was sent by mail and included information on diet and alcohol intake, parity, age at first birth, family history of breast cancer, weight, height, education level and marital status.

An appointment was also made for a mammography screening.

Start Year	1987 (March)
End Year	1990 (December)
Data Sources	Questionnaires Physical measures

Information from health registries is updated every year (1-2 years delay).

Incident cases of cancer were ascertained by record linkages of the study population with the National Swedish Cancer Register and the Regional Cancer Registers. Cardiovascular and other diseases, as well as surgeries and causes of death, are identified by linkage to the National Inpatient Register and other registries at the Swedish Board of Health and Welfare. Dates of deaths are ascertained through the Swedish Death Register.

Start Year	1987 (March)
End Year	2016 (December)
Data Sources	Administrative databases
Administrative Databases	Health databases Vital statistics databases

The second questionnaire collected information on diet and alcohol intake, dietary supplements, family history of cancer and myocardial infarction, age at menarche, history of oral contraceptive use, age at menopause, postmenopausal hormone use, disease diagnoses, body weight across the life course, current waist and hip circumferences, medication use and lifestyle factors including history of cigarette smoking, physical activity and sleep habits.

Information on dates that participants moved out of the study area was obtained by linkage with the Swedish Population Register.

Start Year	1997 (September)
End Year	1997 (December)
Data Sources	Questionnaires Administrative databases
Administrative Databases	Socioeconomic databases

Participants from Uppsala were invited to participate in a health examination including measures of height, weight, waist and hip circumferences, blood pressure and a DXA scan. Additional questionnaires were completed.

Blood, urine and adipose tissue were also collected.

Start Year	2003 (September)
End Year	2009 (September)
Data Sources	Questionnaires Physical measures Biosamples
Biosamples	Blood Urine Tissues : Adipose tissue

Saliva was collected at different time points between 2005 and 2008.

Start Year	2005 (January)
End Year	2008 (December)
Data Sources	Biosamples
Biosamples	Saliva

The 2008 questionnaire collected information including general health status, disease diagnoses, current body weight, height, waist and hip circumferences, dental health, medication use, sleep habits, urine and bowel habits, family history of selected diseases, stress and social support.

Start Year	2008 (September)
End Year	2008 (December)
Data Sources	Questionnaires

The fourth questionnaire collected information on diet and alcohol intake, dietary supplements, smoking, physical activity and sun habits.

Start Year	2009 (April)
End Year	2009 (December)
Data Sources	Questionnaires

In a second recruitment round, additional SMC participants were invited for inclusion in the clinical subcohort. As in recruitment 1, the women took part in a health examination including measures of height, weight, waist, hip, upper arm and calf circumferences, sagittal height, blood pressure and pulse. Functional tests of grip strenght, chair stand and walking were performed. Additional questionnaires were also completed.

In addition, a cognitive function test via telephone was conducted. This round was partly a targeted recruitment of the oldest cohort participants (visited in their homes if needed), who also completed a MMSE (Mini Mental State Examination) test in person.

Blood, urine, adipose tissue and faeces were also collected.

Start Year	2010 (April)
End Year	2015 (September)
Data Sources	Questionnaires Cognitive measures Physical measures Biosamples
Biosamples	Blood Urine Tissues : Adipose tissue Others : Faeces

Women who participated in the first SMC clinical subcohort in 2003-2009 are currently recruited for repeated collection of biological samples and clinical measurements.

The women take part in a health examination including measures of height, weight, waist, hip, upper arm and calf circumferences, sagittal height, blood pressure, and a DXA scan. Functional tests of grip strenght, chair stand and walking are performed. Additional questionnaires are also completed.

In addition, a cognitive function test via telephone is conducted and a completed a MMSE (Mini Mental State Examination) test is done in person.

Blood, urine, adipose tissue and faeces are collected.

Start Year	2015 (October)
End Year	2016 (December)
Data Sources	Questionnaires Cognitive measures Physical measures Biosamples
Biosamples	Blood Urine Tissues : Adipose tissue Others : Faeces

The general aim of the study is to assess a wide range of modifiable lifestyle factors (diet, dietary supplements, physical activity, smoking, alcohol, body weight and other anthropometric measures, etc.) and genetic factors in a large population-based longitudinal cohort of Swedish middle-aged and elderly women.

Extensive questionnaire-based data on diet and other lifestyle factors enables studies of relevance for primary and secondary prevention of cancer (common and rare types), cardiovascular diseases, type 2 diabetes, osteoporosis, neurodegenerative diseases, age-related cataract, rheumatoid arthritis, lower urinary tract symptoms, chronic obstructive pulmonary disease, obesity etc.
Extensive register-based information on health status facilitates studies of multimorbidity, polypharmacy, ageing, and overall and cause-specific mortality.
Biorepository with a broad spectrum of samples (saliva, blood, urine, adipose tissue, faeces), complemented with clinical data, enables studies of genetic factors and other factors of relevance for detection of biomarkers for early diagnosis and progression.

Search Variables

Overview

Acronym	SMC
Website	SMC Website
Investigators	Prof. Alicja Wolk (Karolinska Institutet)
Contacts	Prof. Alicja Wolk (Karolinska Institutet) Dr. Niclas Hakansson (Karolinska Institutet)
Start Year	1987

Study Design

Study Design	Cohort
General Information on Follow Up (profile, frequency)	After baseline, participants were followed-up three times for updated exposure information, in 1997, 2008 and 2009. Information on health status is updated every year by linkage to registries.
Recruitment Target	Individuals
Number of Participants	66,651
Number of Participants with Biosamples	14,904
Supplementary Information about Number of Participants	Saliva sample: 8744 participants Clinical subcohort samples (Cycle 1): 6231 participants Clinical subcohort samples (Cycle 2): ~400 (June 2016; ongoing)

Access

Access to external researchers or third parties provided or foreseen.

Data (questionnaire-derived, measured...)
Biosamples

Marker Paper

Harris H, Håkansson N, Olofsson C, Stackelberg O, Julin B, Åkesson A, et al. The Swedish mammography cohort and the cohort of Swedish men: study design and characteristics of two population-based longitudinal cohorts. OA Epidemiology 2013 Oct 01;1(2):16.

Study Timeline

Each colour in the timeline graph below represents a separate Study Population, while each segment in the graph represents a separate Data Collection Event. Clicking on a segment gives more detailed information on a Data Collection Event.

Population

SMC population

The cohort is composed of women born between 1914 and 1948 and residing in the Uppsala County of central Sweden and in the adjacent Västmanland County at the time of recruitment.

Sources of Recruitment

General Population	Selected sample
Supplementary Information	All women born between 1914 and 1948 were invited to participate.

Selection Criteria

Gender	Women only
Age	Minimum age 39, Maximum age 76
Country	Sweden
Territory	Uppsala and Västmanland Counties (central Sweden)

Sample Size

Number of Participants	66,651
Number of Participants with Biosamples	14,904
Supplementary Information about Number of Participants	1987: 66 651 participants 1997: 39 227 participants 2008: 30 621 participants 2009: 25 332 participants Saliva sample: 8744 participants Clinical subcohort samples (Cycle 1): 6,231 participants Clinical subcohort samples (Cycle 2): ~400 participants (June 2016; ongoing)

Data Collection Events

Name	Description	Start	End
SMC - 1987 (baseline)	The questionnaire was sent by mail and included...	1987 (March)	1990 (December)
SMC - Registries	Information from health registries is updated...	1987 (March)	2016 (December)
SMC - 1997 (2nd follow-up)	The second questionnaire collected information...	1997 (September)	1997 (December)
SMC - Clinical exmination (Cycle 1, recruitment 1)	Participants from Uppsala were invited to...	2003 (September)	2009 (September)
SMC - Saliva	Saliva was collected at different time points...	2005 (January)	2008 (December)
SMC - 2008 (3rd (a) follow-up)	The 2008 questionnaire collected information...	2008 (September)	2008 (December)
SMC - 2009 (3rd (b) follow-up)	The fourth questionnaire collected information...	2009 (April)	2009 (December)
SMC - Clinical examination (Cycle 1, recruitment 2)	In a second recruitment round, additional SMC...	2010 (April)	2015 (September)
SMC - Clinical examination (Cycle 2)	Women who participated in the first SMC...	2015 (October)	2016 (December)

Variable Classification

Email	Alicja.Wolk@ki.se
Phone	+46 8 5248 6170
Institution	Karolinska Institutet
Address	Stockholm Sweden

Email	Alicja.Wolk@ki.se
Phone	+46 8 5248 6170
Institution	Karolinska Institutet
Address	Stockholm Sweden

Email	Niclas.Hakansson@ki.se
Phone	+46 8 5248 7080
Institution	Karolinska Institutet
Address	Stockholm Sweden

SMC - 1987 (baseline)

SMC - Registries

SMC - 1997 (2nd follow-up)

SMC - Clinical exmination (Cycle 1, recruitment 1)

SMC - Saliva

SMC - 2008 (3rd (a) follow-up)

SMC - 2009 (3rd (b) follow-up)

SMC - Clinical examination (Cycle 1, recruitment 2)

SMC - Clinical examination (Cycle 2)