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A multi-model ensemble-based system for seasonal-to-interannual prediction has been developed in a joint European project known as DEMETER (Development of a European Multimodel Ensemble Prediction System for Seasonal to Interannual Prediction). The DEMETER system comprises seven global atmosphere–ocean coupled models, each running from an ensemble of initial conditions. Comprehensive hindcast evaluation demonstrates the enhanced reliability and skill of the multimodel ensemble over a more conventional single-model ensemble approach. In addition, innovative examples of the application of seasonal ensemble forecasts in malaria and crop yield prediction are discussed. The strategy followed in DEMETER deals with important problems such as communication across disciplines, downscaling of climate simulations, and use of probabilistic forecast information in the applications sector, illustrating the economic value of seasonal-to-interannual prediction for society as a whole. The DEMETER project has been funded by the European Union under the Contract EVK2-1999-00024.

Aims/hypothesis: An inverse association has consistently been shown between diabetes and prostate cancer incidence. We investigated whether lower prostate cancer incidence among men with diabetes is attributable to lower detection due to prostate cancer screening patterns. Methods: We studied a population-based historical cohort of 1,034,074 Israeli men aged 21–90 years, without a previous history of cancer. The cohort was followed-up from 2002 to 2012, according to diabetes morbidity, for frequency of prostate-specific antigen (PSA) testing, mean PSA values and detection of prostate cancer, after adjustment for age, ethnic origin, socioeconomic status and PSA testing. Results: In January 2002, 74,756 men had prevalent diabetes. During the 11 year follow-up, 765,483 (74%) remained diabetes-free and 193,835 developed diabetes. Approximately 10% more PSA screening was performed in men with than without diabetes, but the rate of PSA positivity (>4 µg/l) was 20% lower in men with diabetes. PSA values were already significantly lower in men who developed diabetes than in those who did not, 3 years before diabetes diagnosis. Reduced prostate cancer risk was observed among men with incident diabetes only for low–moderate grade tumours (Gleason score 2–6: adjusted HR 0.83; 95% CI 0.77, 0.89). No association was observed for high-grade tumours (Gleason score 7–10: HR 0.99; 95% CI 0.88, 1.11). Conclusions/interpretation: Our findings suggest that diabetes comorbidity is a factor to be considered in prostate cancer screening strategies, and specifically in the interpretation of PSA levels. Furthermore, our demonstration of reduced incidence of low–moderate grade but not high-grade prostate cancer tumours among men with diabetes supports the possibility that low PSA levels, rather than lower tumour risk, explains the observed reduced incidence of prostate cancer in men with diabetes. Trial registration:: ClinicalTrials.gov NCT02072902 © 2016, The Author(s).