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E3N
Sponsor study identifier
observational
100,000
1 country
1
Study Start
June 15, 1990
Actual (reported)Primary Completion
November 15, 1991
Actual (reported)Study Completion
December 31, 2046
EstimatedPlanned date reported by the registry; this milestone is not confirmed as achieved.
The French E3N cohort was initiated in 1990 to investigate the risk factors associated with cancer and other major non-communicable diseases in women. The participants were insured through a national health system that primarily covered teachers, and were enrolled from 1990 after returning baseline self-administered questionnaires and providing informed consent. The cohort comprised nearly 100 000 women with baseline ages ranging from 40 to 65 years. Follow-up questionnaires were sent approximately every 2-3 years after the baseline and addressed general and lifestyle characteristics together with medical events (cancer, cardiovascular diseases, diabetes, depression, fractures and asthma, among others). The follow-up questionnaire response rate remained stable at approximately 80%. A biological material bank was generated and included blood samples collected from 25 000 women and saliva samples from an additional 47 000 women. Ageing among the E3N cohort provided the opportunity to investigate factors related to agerelated diseases and conditions as well as disease survival.
Registry-reported information. Elapsed time and enrollment totals alone do not measure study progress or recruitment pace.
December 31, 2046
EstimatedPlanned date reported by the registry; this milestone is not confirmed as achieved.
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Dates and qualifiers reported by the registry. Estimated dates do not confirm that a milestone has occurred.
June 15, 1990
Actual (reported)November 15, 1991
Actual (reported)July 27, 2017
Actual (reported)September 15, 2017
Actual (reported)December 31, 2046
EstimatedPlanned date reported by the registry; this milestone is not confirmed as achieved.
Anthropometric measurements
Height, weight, hip circumference and waist circumference
From 1990 until now
Educational level
1990
Professional activity
Insee categories
1992 and 2005
Age at cessation of activity
From 2005 until now
The cohort comprised nearly 100 000 women with baseline ages ranging from 40 to 65 years, all insured through a French national health system (MGEN).
Villejuif, 94800, France
Clavel-Chapelon F; E3N Study Group. Cohort Profile: The French E3N Cohort Study. Int J Epidemiol. 2015 Jun;44(3):801-9. doi: 10.1093/ije/dyu184. Epub 2014 Sep 10.
Danjou AMN, Coudon T, Praud D, Leveque E, Faure E, Salizzoni P, Le Romancer M, Severi G, Mancini FR, Leffondre K, Dossus L, Fervers B. Long-term airborne dioxin exposure and breast cancer risk in a case-control study nested within the French E3N prospective cohort. Environ Int. 2019 Mar;124:236-248. doi: 10.1016/j.envint.2019.01.001. Epub 2019 Jan 16.
25000 blood samples; 47000 saliva samples
Gianluca Severi, PhD
INSERM (Institut National de la Sante et de la Recherche Medicale)
100,000 participants (actual enrollment reported by the registry).
First Submitted
July 27, 2017
First Posted
September 15, 2017
Study Start
June 15, 1990
Actual (reported)Menstrual factors
Age at menarche, length of menstrual cycle
From 1990 to 2002
Reproductive history
Number of pregnancies, age at each pregnancy, durations and outcomes of pregnancies, breastfeeding, infertility
From 1990 to 1992
Menopause
Age, type
1990, 1995, 1997, 2000, 2002, 2005
Hormonal Treatments
Menopausal Hormonal Treatments (MHT), oral contraceptives
From 1992 to 2008
Tobacco consumption
Type, quantity, time of smoking
From 1990 until now
Alcohol consumption
Type of alcohol, quantity
1993, 1997, 2005
Physical activity
Moderate and intense activity, sedentarity
1990,1997,2002, 2005, 2014
Diet questionnaire
Precise annual diet questionnaire
1993 and 2002
Family history of diseases
Cancer, diabetes and cardiovascular diseases
1990 to 2005
Medication use
linked with the drug reimbursement files from the health insurance
From 1990 until now
Medical and surgical history
From 1990 until now
Mental Health
Centre for Epidemiologic Studies Depression Scale (CESD) and Depression
From 1990 until now
Health outcomes
From 1990 until now
Contact the study team to confirm eligibility.
Lajous M, Boutron-Ruault MC, Fabre A, Clavel-Chapelon F, Romieu I. Carbohydrate intake, glycemic index, glycemic load, and risk of postmenopausal breast cancer in a prospective study of French women. Am J Clin Nutr. 2008 May;87(5):1384-91. doi: 10.1093/ajcn/87.5.1384.
Fournier A, Cairat M, Severi G, Gunter MJ, Rinaldi S, Dossus L. Use of menopausal hormone therapy and ovarian cancer risk in a French cohort study. J Natl Cancer Inst. 2023 Jun 8;115(6):671-679. doi: 10.1093/jnci/djad035.
Paoletti X, Clavel-Chapelon F. Induced and spontaneous abortion and breast cancer risk: results from the E3N cohort study. Int J Cancer. 2003 Aug 20;106(2):270-6. doi: 10.1002/ijc.11203.
Clavel-Chapelon F; E3N-EPIC Group. Differential effects of reproductive factors on the risk of pre- and postmenopausal breast cancer. Results from a large cohort of French women. Br J Cancer. 2002 Mar 4;86(5):723-7. doi: 10.1038/sj.bjc.6600124.
Fournier A, Berrino F, Riboli E, Avenel V, Clavel-Chapelon F. Breast cancer risk in relation to different types of hormone replacement therapy in the E3N-EPIC cohort. Int J Cancer. 2005 Apr 10;114(3):448-54. doi: 10.1002/ijc.20710.
Fournier A, Fabre A, Mesrine S, Boutron-Ruault MC, Berrino F, Clavel-Chapelon F. Use of different postmenopausal hormone therapies and risk of histology- and hormone receptor-defined invasive breast cancer. J Clin Oncol. 2008 Mar 10;26(8):1260-8. doi: 10.1200/JCO.2007.13.4338.
Dusser P, Nguyen Y, Perrin C, Frenoy P, Mariette X, Boutron-Ruault MC, Severi G, Salliot C, Seror R. Birth length and perinatal exposures and rheumatoid arthritis risk in the E3N cohort. RMD Open. 2026 Apr 9;12(2):e006415. doi: 10.1136/rmdopen-2025-006415.
Dusser P, Nguyen Y, Perrin C, Frenoy P, Mariette X, Boutron-Ruault MC, Varraso R, Severi G, Salliot C, Seror R. Early-life animal and farming exposures and the risk of rheumatoid arthritis: findings from the E3N French cohort study. RMD Open. 2025 Dec 7;11(4):e005954. doi: 10.1136/rmdopen-2025-005954.
Auguste A, Jansana A, Freisling H, Ferrari P, Laouali N, Severi G, Kvaskoff M. Impact of Hypertension on Cancer Stage at Diagnosis Among French Women: The E3N Prospective Cohort. Cancer Med. 2025 Aug;14(15):e71021. doi: 10.1002/cam4.71021.
Klu YE, Amazouz H, Canonico M, Guenel P, Kvaskoff M, Severi G, Radoi L, Auguste A. Association Between Hormonal Factors and Risk of Lung and Upper Aerodigestive Tract Cancer in French Women: The E3N Prospective Cohort Study. Cancer Rep (Hoboken). 2025 Jun;8(6):e70223. doi: 10.1002/cnr2.70223.
Koemel NA, Shah S, Senior AM, Severi G, Mancini FR, Gill TP, Simpson SJ, Raubenheimer D, Boutron-Ruault MC, Laouali N, Skilton MR. Macronutrient composition of plant-based diets and breast cancer risk: the E3N prospective cohort study. Eur J Nutr. 2024 Aug;63(5):1771-1781. doi: 10.1007/s00394-024-03379-x. Epub 2024 Apr 18.
Shah S, Mahamat-Saleh Y, Ait-Hadad W, Koemel NA, Varraso R, Boutron-Ruault MC, Laouali N. Long-term adherence to healthful and unhealthful plant-based diets and breast cancer risk overall and by hormone receptor and histologic subtypes among postmenopausal females. Am J Clin Nutr. 2023 Mar;117(3):467-476. doi: 10.1016/j.ajcnut.2022.11.019.
Shah S, Mahamat-Saleh Y, Hajji-Louati M, Correia E, Oulhote Y, Boutron-Ruault MC, Laouali N. Palaeolithic diet score and risk of breast cancer among postmenopausal women overall and by hormone receptor and histologic subtypes. Eur J Clin Nutr. 2023 May;77(5):596-602. doi: 10.1038/s41430-023-01267-x. Epub 2023 Feb 1.
Frenoy P, Perduca V, Cano-Sancho G, Antignac JP, Severi G, Mancini FR. Application of two statistical approaches (Bayesian Kernel Machine Regression and Principal Component Regression) to assess breast cancer risk in association to exposure to mixtures of brominated flame retardants and per- and polyfluorinated alkylated substances in the E3N cohort. Environ Health. 2022 Feb 26;21(1):27. doi: 10.1186/s12940-022-00840-4.
Madika AL, MacDonald CJ, Gelot A, Hitier S, Mounier-Vehier C, Beraud G, Kvaskoff M, Boutron-Ruault MC, Bonnet F. Hysterectomy, non-malignant gynecological diseases, and the risk of incident hypertension: The E3N prospective cohort. Maturitas. 2021 Aug;150:22-29. doi: 10.1016/j.maturitas.2021.06.001. Epub 2021 Jun 12.
Laouali N, Shah S, MacDonald CJ, Mahamat-Saleh Y, El Fatouhi D, Mancini F, Fagherazzi G, Boutron-Ruault MC. BMI in the Associations of Plant-Based Diets with Type 2 Diabetes and Hypertension Risks in Women: The E3N Prospective Cohort Study. J Nutr. 2021 Sep 4;151(9):2731-2740. doi: 10.1093/jn/nxab158.
Cairat M, Al Rahmoun M, Gunter MJ, Severi G, Dossus L, Fournier A. Antiplatelet Drug Use and Breast Cancer Risk in a Prospective Cohort of Postmenopausal Women. Cancer Epidemiol Biomarkers Prev. 2021 Apr;30(4):643-652. doi: 10.1158/1055-9965.EPI-20-1292. Epub 2021 Feb 2.
Azevedo Da Silva M, Fournier A, Boutron-Ruault MC, Balkau B, Bonnet F, Nabi H, Fagherazzi G. Increased risk of type 2 diabetes in antidepressant users: evidence from a 6-year longitudinal study in the E3N cohort. Diabet Med. 2020 Nov;37(11):1866-1873. doi: 10.1111/dme.14345. Epub 2020 Jul 2.
Mahamat-Saleh Y, Cervenka I, Al Rahmoun M, Savoye I, Mancini FR, Trichopoulou A, Boutron-Ruault MC, Kvaskoff M. Mediterranean dietary pattern and skin cancer risk: A prospective cohort study in French women. Am J Clin Nutr. 2019 Oct 1;110(4):993-1002. doi: 10.1093/ajcn/nqz173.
Primary Completion
November 15, 1991
Actual (reported)Study Completion
December 31, 2046
EstimatedPlanned date reported by the registry; this milestone is not confirmed as achieved.
Last Updated
June 25, 2026
Record last verified: 2026-06
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