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Health 2020: Decades of discoveries and still going strong

Wednesday 21 October, 2020

From alcohol to exercise, fatty acids to sugary drinks, we know more than ever about what affects our risk of cancer. Much of this is thanks to one extensive study – Health 2020.

Since 1990, Health 2020 – also known as the Melbourne Collaborative Cohort Study (MCCS) – has been investigating the roles of diet and lifestyle in causing cancer and other diseases.

When the study began, diet and nutrition were considered potentially important factors affecting cancer risk, but there wasn’t much evidence to inform the prevention of the disease. The study, then under its original name of Health 2000, recruited more than 41,000 Victorian participants between 1990 and 1994, and began gathering extensive information about their health, diet and lifestyle to investigate their impact on cancer risk over time.

Thirty years and more than 900 scientific papers later, things have come a long way.

Some of the biggest breakthroughs of the Health 2020 study relate to diet, exercise and alcohol consumption.

“Health 2020 has been used to investigate associations between diet and a wide range of health outcomes,” Professor Roger Milne, Head of the Cancer Epidemiology Division at Cancer Council Victoria and Chief Investigator of the MCCS, said.

Professor Roger Milne, Chief Investigator of the MCCS

“Dietary patterns have been investigated in relation to Type 2 diabetes; lung, urothelial and breast cancers; healthy ageing and more.”

The findings all support the health benefits of diets based on plenty of fruits and vegetables with a limited meat intake. Health 2020 researchers have also found evidence of associations between fatty acids and health outcomes, with omega-3 fatty acids – found in fish, walnuts and flaxseeds, among other sources – being preferable to omega-6, often found in seed oils and margarine.

The long-running study has also given important evidence on what ought to be avoided or reduced in our diets – particularly sugary and alcoholic drinks.

Research shows that drinking sugary drinks is associated with increased abdominal fat,  increases the risk of uterus, oesophageal, and aggressive prostate cancer, among several others. Health 2020 research has also shown that frequent consumption of sugary drinks is linked to cancer risk regardless of a person’s body weight.

By helping increase the awareness of these risks, Health 2020 is helping people make better choices to lower their risk of cancer, and providing public health professionals and policymakers with data to inform their decisions.

And it isn’t just sugary drinks we now know more about. Extensive research on alcohol’s effects has also delivered important findings.

“In addition to collecting information on recent consumption of alcoholic beverages, we also collected data on historical drinking patterns throughout adulthood,” Prof Milne said. “These data have been used to assess the associated risks of several types of cancer.”

As well as contributing to the risks of being overweight, more specific effects of alcohol intake have also been discovered. Recently researchers found that a woman who drinks before her first full-term pregnancy has a 35% greater risk of breast cancer than one who doesn’t, while alcohol can also significantly increase men's and women's risk of bowel cancer – particularly when combined with smoking and being overweight.

But while Health 2020 has discovered a lot about the impact of diet and lifestyle, the study couldn’t have predicted the advancements it would make in understanding a third factor: genetics.

“What we did not anticipate at the start of the study was the rapid growth in genomic technology and knowledge,” Professor Graham Giles said. Prof Giles was the Founding Investigator of Health 2020.

“Health 2020 blood samples, which we collected originally solely to measure dietary and other markers, became a highly valuable source of DNA to examine genetic risk factors for disease. This field of research has been our principal focus for the past 15 years.”

This focus has led to the identification of hundreds of common genetic variants associated with the risk of more common cancers such as breast, bowel and prostate cancer. It has also led to the discovery of many novel genetic variants linked to rarer cancers, like ovarian and pancreatic cancer. Discoveries like these are often made by collaborating with international studies, to enable Health 2020 to gather the data required for these types of studies.  

Thanks to the support of people like you, Health 2020 is continuing to make such discoveries and have a global impact to this day, and continues to ensure that fewer people in Australia are diagnosed with cancer. Now joined by another large, Victorian-led study – the Australian Breakthrough Cancer (ABC) Study – Health 2020 shows no signs yet of slowing down.

“Health 2020 researchers currently lead international research endeavours, including projects to identify modifiable risk factors for stomach and bladder cancer," Prof Milne said.

“For our own research and collaborative studies with Australian and international research groups, Health 2020 continues to be a valuable resource. This study is still going strong.”

Read more about the important Health 2020 work you’re supporting.

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