The COLS Plan


A cohort of one million people, all residing in Colorado, will enable researchers to study community dynamics all the way down to the neighborhood level. Studies with fewer participants or a larger geographic area cannot hope to understand communities at that level of detail.

In order to study the progression of rare diseases, it is essential to follow a large cohort over time because so few people will develop a rare disease. Ovarian cancer is a good example. It is relatively rare: it occurs in 1 in 10,000 women per year. In the COLS cohort, roughly 50 women per year will be diagnosed with ovarian cancer. Such a population is large enough to support a wide range of investigations to discover biomarkers and develop novel diagnostics and therapeutics.

The size of the COLS cohort will also be valuable to study common diseases. Take type 2 diabetes: in Colorado, over 1.3 million people are prediabetic. We know that the causes of the disease are a combination of genetics, environment, and behaviors. Prediabetes manifests itself in many different ways and could benefit from being studied as multiple conditions. Thus, there needs to be a large enough cohort in order for a sufficient number of participants to be represented in each subgroup.