Scientific Concept of the National Cohort (status ... - Nationale Kohorte

A.3
A.3 Study design
ovarian carcinoma 450 and to be associated with an increased risk of thromboembolism and
cardiovascular events 451, 452 . Hormone replacement therapy has been shown to be associated
with risk of breast and ovarian cancer 450 and CVD 453. Therefore, we will obtain detailed
information on menarche, reproductive history, menopause, and hormone use.
Male lower urinary tract symptoms, benign prostatic hyperplasia, enlargement of the prostate,
and bladder outlet obstruction are common among aging men and will increase in socioeconomic
and medical importance at a time of increased life expectancy and aging 454, 455 .
For elderly men, benign prostatic hyperplasia has considerable influence on quality of life.
Instruments:
In the women’s questionnaire, information will be gathered about menstruation (date of onset,
duration of the cycles), pregnancies (number, outcomes), breast feeding (duration for
each child), menopause (date of onset, symptoms), and intake of exogenous hormones (for
birth control and hormone replacement therapy) and about breast and other gynecological
diseases and operations.
For men, we will obtain information on benign prostatic hyperplasia. Further specific questions
for men that are still under discussion are related to, for example hormonal intake,
fertility, and erectile function.
Smoking, alcohol, and drugs
The leading lifestyle exposures constituting risk factors for a wide range of diseases are
smoking 268 and alcohol consumption 267 and need to be taken into account as confounders
in many analyses. Thus, we will aim to quantify life-long tobacco and alcohol consumption
and information on drinking patterns. Drug use is also a phenomenon of increasing concern
as there is an increasing prevalence of use in the younger population 456 and because some
drugs have been shown to induce or “exacerbate” psychiatric disorders and injuries. For
instance, the association between cannabis consumption and schizophrenia is under discussion
457, 458 , and there may be an association with mental health. Therefore, we will obtain
information on use of selected illegal drugs.
Instruments:
In order to be able to quantify smoking history, information on life-long smoking habits –
active as well as passive – will be obtained, complying with published recommendations
for questionnaires on smoking habits 459 . The questionnaire for tobacco use that follows
published recommendations for questionnaires on smoking 459 covers regular and occasional
smoking, former smoking, smoking duration, periods of quitting, and average number
smoked for filter, nonfilter and hand-rolled cigarettes, cigars, cigarillos, and pipes. Information
on passive smoking will be collected using questions concerning home, working, and
leisure environment.
Questionnaire modules on alcohol consumption will enable us to quantify alcohol consumption
and to assess drinking patterns and have been adapted from previous epidemiologic
studies (e.g., KORA, EPIC, and HAPIEE study). Alcohol consumption will be assessed by
using questions about usual frequency, quantity, and type of alcohol consumed during the
past 12 months such that alcohol consumption can be calculated in g/day. Consumption
during weekdays and weekends will be documented separately. The Alcohol abuse and dependence
(BASIC) questionnaire 460 is a 6-item, short tool that can be used to screen these
conditions and has previously been used in population-based studies in Germany. It can
also be used to classify risky alcohol consumption. Binge drinking will be assessed using
the modified HAPIEE questionnaire 461 .
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