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Environment and Lifestyle Epidemiology Branch (ENV)


Aim 1. To investigate environmental and lifestyle causes of cancer

Environmental and lifestyle causes of cancer provide the major avenues for primary prevention. The rationale for continued research in this domain is that, among several cancer types with unknown causes, variations in incidence by geography, generation, or sociodemographic factors point to environmental origins. Furthermore, among known environmental and lifestyle causes of cancer, the exposure–response association is not well known, in particular at low exposure levels.


Oesophageal cancer
Oesophageal Squamous Cell Carcinoma African Prevention Research (ESCCAPE): a collaborative research effort to investigate the etiological epidemiology of oesophageal squamous cell carcinoma in the high-incidence belt in East Africa; major case–control studies are under way in Eldoret (Kenya), in Moshi, Kilimanjaro (United Republic of Tanzania), and in Blantyre (Malawi), and further pilot work is being conducted in Ethiopia (https://esccape.iarc.fr/).

Testicular cancer
The TESTIS, SIGEXPO, and SIGEXPOSOME projects: a case–control study of testicular cancer in France (TESTIS), with the development of a contemporary dust measurement-based pesticide exposure metric (SIGEXPO) and an exploration of possible biomarkers of pesticide exposure (SIGEXPOSOME).

The NORD-TEST study: a registry-based study in the Nordic countries investigating parental occupational exposures and risk of testicular cancer in their offspring.

Childhood cancer
Collaboration in the Childhood Cancer and Leukemia International Consortium (CLIC): a pooled analysis of case–control studies on childhood leukaemia investigating the role of potential lifestyle and environmental risk factors (https://clic.iarc.fr/).

The Global Acute Leukaemia network (GALnet): a consortium established to assess epidemiological, molecular, and clinical characteristics of childhood leukaemia in high- and low-incidence areas around the world (https://galnet.iarc.fr/).

The Environment and Child Health International Consortium (ECHIG) has been established to strengthen the collaboration and coordinate the activities of the birth cohorts from China, Denmark, France, Japan, and Norway, among others.

Environmental or lifestyle exposures
Uranium contamination and cancer risk in the West Rand region of South Africa, including a study on analysing human exposure to uranium in composite hair samples from communities in the West Rand region, and retrospective and prospective case series of patients with haematological malignancies from the Chris Hani Baragwanath Academic Hospital in Soweto.

Contamination from the petroleum industry in the Niger Delta together with the United Nations Environment Programme (UNEP) and the Swiss Tropical and Public Health Institute (TPH) and several partners in Nigeria, to be started in 2022.

Tattoos and cancer risk (CRABAT): Despite the high population prevalence of tattoos, knowledge on the health consequences of tattoos is scarce. Research has shown that tattoo pigments contain carcinogenic substances and migrate from the skin into the body. Epidemiological research led by ENV is established in France and Germany.

Aim 2. To study the epidemiology of cancers associated with known and suspected carcinogens in the occupational setting

ENV undertakes investigations of known and suspected carcinogens in the occupational setting, directly informing assessments for worker protection or worker compensation. To date, most evidence on occupational cancer has stemmed from research in high-income countries, where exposures and circumstances differed substantially from those in LMICs in terms of exposure levels, pathways, and co-exposures. ENV’s international network is particularly suited to integrate LMICs into global occupational cancer research and worker protection.


Pesticides and other agricultural exposures
AGRICOH: a research consortium of cohort studies of agricultural workers or pesticide applicators and their families, to investigate the risk of cancer and other diseases related to pesticide exposure and other prevalent agricultural exposures (https://agricoh.iarc.fr/).

The Asbest Chrysotile Cohort Study: a cohort study on occupational exposure to chrysotile asbestos in workers in mines and enrichment factories in the town of Asbest, Russian Federation (https://asbest-study.iarc.fr/).

Various occupational carcinogens
The SYNERGY project: a lung cancer consortium studying lung cancer risk associated with combined occupational exposures and smoking, pooling case–control studies of lung cancer from 13 countries; the project currently focuses on exposure to asbestos, respirable crystalline silica, polycyclic aromatic hydrocarbons (PAHs), chromium, and nickel (https://synergy.iarc.fr/).

Occupational Cancer in LMICs programme: Occupational cancer epidemiology in Europe, Oceania, and North America has over time contributed to improved legislation, awareness, surveillance, and safety for workers, but awareness of and research on cancer in relation to workplace exposures in other parts of the world is often less developed. Encouraged by national governments, ENV is collaborating with the national occupational health experts, starting a programme on occupational cancer in the Russian Federation and the Islamic Republic of Iran.

Aim 3. To study the epidemiology of cancers associated with exposure to low doses of ionizing radiation and to non-ionizing radiation (electromagnetic fields)

Characterization of cancer risks associated with environmental exposures to ionizing radiation remains controversial, especially cancer risks from low-dose protracted ionizing radiation exposure at different stages of life. Furthermore, there remains an open question about whether exposure to electric, magnetic, or electromagnetic fields is associated with an increased risk of certain cancers.


Exposure due to nuclear accidents or nuclear testing
Chernobyl Health Research: long-term research on the health effects of the Chernobyl accident (following the research agenda developed in https://co-cher.iarc.fr/), including on breast cancer and haematological cancers in the affected populations and thyroid cancer risk in young people exposed to radioactive iodine, including assessment of genetic predisposition.

The SEMI-NUC project: cancer risk in residents of areas near the former Semipalatinsk nuclear test site in Kazakhstan (https://semi-nuc.iarc.fr/).

International Expert Group on Long-Term Strategies for Thyroid Health Monitoring after Nuclear Accidents (TM-NUC): to provide scientific information and advice to policy-makers and health professionals, in order to better plan and implement thyroid ultrasound examinations as long-term health monitoring for populations possibly affected by radiation exposure due to nuclear accidents (https://tmnuc.iarc.fr/).

Occupational and medical exposure
The International Nuclear Workers Study (INWORKS): extended follow-up of cancer and all-cause mortality among cohorts of nuclear industry workers in France, the United Kingdom, and the USA.

Epidemiological Study to Quantify Risks for Paediatric Computed Tomography (CT) and to Optimize Doses (EPI-CT): a multinational consortium of cohort studies of children who have undergone CT examination, followed up for childhood cancer (https://epi-ct.iarc.fr/).

Electromagnetic fields
The COSMOS study: an international prospective study of mobile phone users, of which ENV is coordinating the French component (https://cosmos.iarc.fr/).

The INTERPHONE study: a large, multicentre, multinational case–control study of tumours of the brain, acoustic nerve, and parotid gland in relation to radiofrequency fields emitted by mobile phones (https://interphone.iarc.fr/); the INTER-CAL project, which is based on the INTERPHONE study, is exploring the possible impact of bias and confounding.

The ASTRO-RF study: a register-based study in Denmark, Norway, and Sweden on survival after glioma in relation to mobile phone use.

Aim 4. To identify barriers to improving survival of common curable cancers in LMICs

A major focus is on the epidemiology of breast cancer in sub-Saharan Africa, including studies of barriers, within a social and cultural context, to early presentation and diagnosis, treatment, and ultimately survival.


The African Breast Cancer – Disparities in Outcomes (ABC-DO) study: a multinational African study of the entire experience of a patient with breast cancer, to identify determinants and pathways contributing to poor survival; patients are recruited at public hospitals in five countries (Namibia, Nigeria, South Africa, Uganda, and Zambia) and actively followed up using mHealth technology (https://abc-do.iarc.fr/).

Global estimates of maternal orphans study: The intergenerational impact of cancer deaths is rarely given attention; prompted by results in the African Breast Cancer – Disparities in Outcomes (ABC-DO) study, ENV is quantifying the size and impact of this intergenerational effect of cancer deaths globally.

Aim 5. To enable cancer prevention and control through translation of research evidence

This objective, which ENV had initially hosted on behalf of the Agency, is now fully integrated into the Branch, and the related activities are led by ENV, with the respective involvement of other IARC Branches. This captures the activities on cancer prevention recommendations, with a current focus on Europe and Latin America. It also ensures that ENV’s scientific knowledge is reaching the relevant health decision-making bodies for appropriate action.


European Code Against Cancer, 4th edition: an initiative resulting in the development of 12 recommendations to inform the general population about how they can reduce their risk of cancer (https://cancer-code-europe.iarc.fr/).

Latin American and the Caribbean Code Against Cancer, 1st edition: Development of the Code as part of the World Code Against Cancer.

Cancer Prevention Europe: ENV provides the scientific secretariat for this consortium (https://cancerpreventioneurope.iarc.fr/).

Please click here for a brief update on the status of selected larger-scale projects.


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