Acknowledgements: The authors would like to thank the participants, general practitioners, and staff of EPIC-Norfolk.
Authors Contributions: KTK,NW SH and RL were involved in the conception and design of the study. RL drafted the manuscript, with support from KTK and PP. SH contributed to data interpretation. RL was responsible for external data linkage. SH and RL contributed to data collection and acquisition. All authors read and critically revised the manuscript and approved the final manuscript. RL is the guarantor. The corresponding author attests that all listed authors meet authorship criteria and that no others meeting the criteria have been omitted.
Funding: The design and conduct of the EPIC-Norfolk study and collection and management of the data was supported by programme grants from the Medical Research Council UK (G9502233, G0401527) and Cancer Research UK (C864/A8257, C864/A2883). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Competing interests: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf and report: RL,SH,KTK and NW report grants from MRC and CRUK during the conduct of the study; The sponsors had no role in any of the following: study design, data collection, data analysis, interpretation of data, writing of the article, decision to submit it for publication. All authors are independent of funders and sponsors and had access to all the data. No conflicts of interest were declared by any author (apart from the two grants) and they have no other relationships or activities that could appear to have influenced the submitted work.
Ethical approval: The work has ethics committee approval from Norfolk Research Ethics Committee (Rec Ref: 98CN01) for EPIC-Norfolk baseline and later collections. The work was also approved by the East Norfolk and Waveney NHS research governance committee (2005EC07L) and the Norfolk research ethics committee (05/Q0101/191) for the EPIC-Norfolk Third Health Check collection. All participants gave informed signed consent for study participation including access to medical records.
Availability of data and materials: The authors will make the dataset available under a Data Transfer Agreement to any bona fide researcher who wishes to obtain the dataset in order to undertake a replication analysis. Although the dataset is anonymised, the breadth of the data included and the multiplicity of variables that are included in this analysis file as primary variables or confounding factors, means that provision of the dataset to other researchers without a Data Transfer Agreement would constitute a risk. Requests for data sharing/access should be submitted to the EPIC Management Committee ([email protected]).
Transparency: The lead author (the manuscript’s guarantor) affirms that the manuscript is an honest, accurate, and transparent account of the study being reported; that no important aspects of the study have been omitted; and that any discrepancies from the study as planned (and, if relevant, registered) have been explained.
Open access: This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/
Patient and public involvement: The EPIC-Norfolk Study have an active Participants Advisory Panel which meets quarterly to advise on research protocols, suggest ideas and provide feedback on the research including proposed new studies and collaborations. All participants of the EPIC-Norfolk study are informed about the study through regular newsletters as well as public meetings. Information is also disseminated through local community talks in the Norfolk area and science festivals.
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