Richard B. Hayes

Background: Over 90% of Asian American (AsA) adults are first- or second-generation immigrants, undergoing substantial environmental and sociocultural transitions; yet most environmental epidemiology cohorts have included few AsA participants. Methods: The Food and Microbiome Longitudinal Investigation (FAMiLI) is an environmental health cohort enriched with AsA adults (predominantly Korean and Chinese American) and designed to capture environmental exposures, dietary acculturation, and sociocultural factors across immigration generations. Its biobank—including buccal and stool specimens—supports research on the oral and gut microbiomes, human genomics, and other multi-omics. Results: Since its launch in 2018, FAMiLI has completed baseline recruitment and biospecimen collection for 13,183 adults aged 40–75 years. The cohort is now expanding to include an additional 3,000 Asian American adults, bringing the total to approximately 16,000 participants, with an expected distribution of ~50% Asian American and ~50% from other racial/ethnic groups. This expansion provides an opportunity to examine AsA environmental health experiences within the broader U.S. context. Conclusions: FAMiLI is a unique national resource to address priority questions in environmental health, including microbiome and exposome science, individual susceptibility, and large-scale data analytics. Impact: The cohort supports investigation of critical windows of environmental change across the immigration experience, racial and ethnic disparities, and drivers of emerging health outcomes, including cancer, cardiovascular disease, diabetes and other outcomes. This cohort offers essential data to inform prevention strategies and shape public health policy to improve health outcomes in AsA communities.

Supplementary Table S9 shows the predictive value of endoscopy history in GERA.

Supplementary Table S1 shows the descriptive characteristics of study populations in GECCO and CORECT.

Supplementary Table S3 shows the comparison on characteristics between GECCO/CORECT study and GERA Europeans-ancestry participants

Supplementary Figure S5 shows the age-stratified calibration on 5- and 10-year absolute risks based on the PRS-enhanced model stratified by deciles of predicted risk in GERA European ancestry participants.

Supplementary Table S8 shows sequential model comparison using 10-year time-dependent AUC in the GERA European-ancestry participants.

Supplementary Figure S4 shows the family-history-stratified calibration on 5- and 10-year absolute risks based on the PRS-enhanced model stratified by deciles of predicted risk in GERA European ancestry participants.

Supplementary Table S2 shows the descriptive statistics of GERA study participants by racial/ethnic groups and sex.

Supplementary Table S7 shows the 10-year time-dependent AUC estimates of the PRS-enhanced model in the GERA European- ancestry participants.

Supplementary Figure S6 shows the calibration on relative risk of PRS stratified by PRS with 7 bins in groups of different ancestry in the GERA cohort.