The Swedish National March Cohort
In September 1997, the Swedish Cancer Society organized a four-day national fund-raising event, the National March, in almost 3,600 cities and villages around the country. In conjunction with this event, we established the Swedish National March Cohort (SNMC).
Project description
Participants in the march were expected to be particularly motivated to provide valid information. They were invited to fill out a 32-page questionnaire, and three pages of this questionnaire were devoted to physical activity, the main focus of the project. Both previously validated and newly developed questions were used in order to estimate energy expenditure and to distinguish between constant low-level activity and short-term peak activity. We used a new rating scale for self-reports of time spent on different intensity levels of physical activity (and inactivity) during a typical day, allowing estimation of total energy expenditure on an interval scale level. This scale has been shown to be both valid and reliable. Seven pages contained questions about diet, using a 63-item validated semi-quantitative food frequency questionnaire that allows estimation of total energy intake and calorie adjustment. Supplementary questions were asked about intake of fried food, detailed pattern of alcohol intake, dietary supplements and use of health food preparations. Two pages had questions about anthropometrical measures, including height, weight (birth weight, current weight, and weight fluctuations), waist and hip measures (allowing calculations of BMI, lean body mass, waist-hip ratio).
Further, three pages were allocated to questions about various background and possibly confounding factors such as country of birth, environment during childhood and adolescence, birthplace of parents, own education, type of employment. Two pages were about smoking (including passive smoking) and snuff dipping habits. One page was dedicated to vaccination history, two pages to ̽»¨¾«Ñ¡ history, two pages to pharmacological history. Two pages were about sun and UV exposure, possible use of sunbeds, and type of complexion. Five pages were spent on questions concerning the psychosocial history, including validated sets of questions about demands and autonomy at work, life events, self-perceived health, social support, as well as duration and quality of sleep. Sleep disturbances were assessed using a modified version of the Karolinska Sleep Questionnaire (KSQ), a widely used tool to assess quality and restorative function of sleep. One page was about the use of mobile telephones. Two pages were devoted to questions specific for women (age at menarche, parity, infertility, menstruation, menopause, use of oral contraceptives and hormone replacement therapy). Due to the open nature of the National March, the total number of individuals who in reality were given a questionnaire could not be assessed. In total, 43,880 men and women completed the questionnaire.
Follow-up
Essentially complete follow-up has since been attained through multiple record linkages, done approximately biannually, using the individually unique national registration numbers (NRNs) to insure exact linkages. We have linked the cohort to Statistics Swedens Register of the Total Population and Population Changes to obtain dates of death, relocations (with information about the new place of residence) and emigration, if any. Data from the Patient Register (covering all inhospital care and more recently also hospital-provided outpatient care), Cancer Register, and Causes of Death Register held by the National Board of Health and Welfare, have permitted accurate tracking of health and vital status of all cohort members. Another complete update (through 2009 in total 12 years of follow-up) was completed by the end of 2011. Follow-up of the cohort participants is updated through linkage with the cancer and patient registers till the end of 2016; information on mortality is however available till March 2018.
Project leaders and research group
Weimin Ye
ProfessorYlva Trolle Lagerros
Professor/Senior PhysicianRino Bellocco
Senior Lecturer;Visiting ProfessorJustine Debelius
Affiliated to ResearchOlof Nyren
Professor Emeritus/EmeritaHans-Olov Adami
Professor Emeritus/EmeritaTorbjörn Åkerstedt
Professor Emeritus/EmeritaEssi Hantikainen
Mauro Serafini
Faculty of BioSciences and Technology for Food, Agriculture and Environment
Functional Food and Metabolic Stress Prevention Laboratory
Teramo University
Questionnaire and Data dictionary
Publications
Tolvanen L, Ghilotti F, Adami HO, Ye W, Bonn SE, Bellocco R, Lagerros YT
Sci Rep 2023 Apr;13(1):5669
Hummel M, Hantikainen E, Adami HO, Ye W, Bellocco R, Bonn SE, Lagerros YT
BMC Public Health 2022 Mar;22(1):532
Araghi M, Galanti MR, Lundberg M, Liu Z, Ye W, Lager A, Engström G, Alfredsson L, Knutsson A, Norberg M, Wennberg P, Lagerros YT, Bellocco R, Pedersen NL, Östergren PO, Magnusson C
Scand J Public Health 2021 Dec;49(8):833-840
Hantikainen E, Trolle Lagerros Y, Ye W, Serafini M, Adami HO, Bellocco R, Bonn S
Neurology 2021 Feb;96(6):e895-e903
Hallgren M, Vancampfort D, Owen N, Rossell S, Dunstan DW, Bellocco R, Lagerros YT
J Affect Disord 2020 Mar;265():538-544
Hallgren M, Nguyen TT, Owen N, Stubbs B, Vancampfort D, Lundin A, Dunstan D, Bellocco R, Lagerros YT
Br J Psychiatry 2020 Aug;217(2):413-419
Hallgren M, Nguyen TT, Lundin A, Vancampfort D, Stubbs B, Schuch F, et al
Prev Med 2019 Jan;118():38-43
Hantikainen E, Grotta A, Serafini M, Trolle Lagerros Y, Nyren O, Ye W, et al
Int J Epidemiol 2018 12;47(6):1947-1955
Hallgren M, Nguyen TT, Herring MP, McDowell CP, Gordon BR, Stubbs B, Bellocco R, Lagerros YT
Gen Hosp Psychiatry 2019 ;58():45-50
Ã…kerstedt T, Ghilotti F, Grotta A, Zhao H, Adami HO, Trolle-Lagerros Y, et al
J Sleep Res 2019 Feb;28(1):e12712
Hallgren M, Owen N, Stubbs B, Zeebari Z, Vancampfort D, Schuch F, et al
J Affect Disord 2018 12;241():579-585
Roos E, Grotta A, Yang F, Bellocco R, Ye W, Adami HO, et al
Neurology 2018 Apr;90(16):e1413-e1417
Lagerros YT, Hantikainen E, Michaëlsson K, Ye W, Adami HO, Bellocco R
Eur. J. Epidemiol. 2017 11;32(11):983-991
Ã…kerstedt T, Ghilotti F, Grotta A, Bellavia A, Lagerros YT, Bellocco R
Eur. J. Epidemiol. 2017 10;32(10):881-891
Araghi M, Rosaria Galanti M, Lundberg M, Lager A, Engström G, Alfredsson L, et al
Int. J. Cancer 2017 08;141(4):687-693
Araghi M, Galanti MR, Lundberg M, Liu Z, Ye W, Lager A, Engström G, Manjer J, Alfredsson L, Knutsson A, Norberg M, Palmqvist R, Gylling B, Wennberg P, Lagerros YT, Bellocco R, Pedersen NL, Östergren PO, Magnusson C
Scand J Public Health 2017 Dec;45(8):741-748
Araghi M, Galanti MR, Lundberg M, Liu Z, Ye W, Lager A, et al
Scand J Public Health 2017 Dec;45(8):741-748
Yang F, Pedersen NL, Ye W, Liu Z, Norberg M, Forsgren L, et al
Int J Epidemiol 2017 06;46(3):872-880
Colarusso L, Serafini M, Lagerros YT, Nyren O, La Vecchia C, Rossi M, et al
Nutrition 2017 Jan;33():234-239
Trolle Lagerros Y, Hantikainen E, Mariosa D, Ye W, Adami HO, Grotta A, et al
Int J Epidemiol 2017 06;46(3):795-795e
Hantikainen E, Grotta A, Ye W, Adami HO, Surkan PJ, Serafini M, et al
Bone 2016 09;90():31-6
Bellocco R, Marrone G, Ye W, Nyrén O, Adami HO, Mariosa D, et al
Eur. J. Epidemiol. 2016 04;31(4):395-404
Grotta A, Bottai M, Adami HO, Adams SA, Akre O, Blair SN, et al
World J Urol 2015 Oct;33(10):1495-502
Markt SC, Grotta A, Nyren O, Adami HO, Mucci LA, Valdimarsdottir UA, et al
Sleep 2015 Sep;38(9):1405-10
Yang F, Trolle Lagerros Y, Bellocco R, Adami HO, Fang F, Pedersen NL, et al
Brain 2015 Feb;138(Pt 2):269-75
Hergens MP, Galanti R, Hansson J, Fredlund P, Ahlbom A, Alfredsson L, et al
Epidemiology 2014 Nov;25(6):872-6
Westerlund A, Bottai M, Adami HO, Bellocco R, Nyrén O, Åkerstedt T, et al
Sleep Med. 2014 Oct;15(10):1196-203
Andersen K, Mariosa D, Adami HO, Held C, Ingelsson E, Lagerros YT, et al
Circ Heart Fail 2014 Sep;7(5):701-8
Hansson J, Galanti MR, Hergens MP, Fredlund P, Ahlbom A, Alfredsson L, et al
J. Intern. Med. 2014 Jul;276(1):87-95
Hansson J, Galanti MR, Hergens MP, Fredlund P, Ahlbom A, Alfredsson L, et al
Eur. J. Epidemiol. 2012 Oct;27(10):771-9
Bellocco R, Jia C, Ye W, Lagerros YT
Eur. J. Epidemiol. 2010 Nov;25(11):777-88
Lagerros YT, Bellocco R, Adami HO, Nyrén O
Eur. J. Epidemiol. 2009 ;24(4):161-9
Press releases
(The Mental Elf, Aug 2020)
(Corriere della serra, May 2018 in Italian)
(Washington Post, May 2018)
(Wiley online, May 2018)
(KI website, Aug 2014)