CRisP

Personalizing Cancer Prevention

Project leader: Henrik Grönberg
Project period: 2008-2018
Main financing: The Swedish Research Council and Märit and Hans Rausing

CRisP is a translational research environment at one of the world’s leading medical universities, Karolinska Institutet. Through a cross-disciplinary and collaborative approach, focusing on individualized cancer risk prediction and prevention, we develop strategies that decrease the mortality of breast and prostate cancer.

Breast cancer is the most common cancer among women in Sweden with almost 8,000 new cases annually. In Sweden 1,500 women die from breast cancer yearly but there is a remarkable difference between outcomes of localized vs advanced disease.
Prostate cancer is the most common cancer among men in Sweden today and yearly almost 10,000 new cases are diagnosed. Despite the old age of onset, the morbidity and mortality of this cancer is substantial with more than 2,500 deaths annually.

We know that cancer mortality can be reduced if cases are detected and treated early, but there is a problem with over-diagnosis and over-treatment. What if we instead could predict the risk for aggressive cancers? Our research focuses on understanding cancer risk and how to design individualized prevention strategies.

About CRisP

Financed by the Swedish Research Council through a 10-year Linnaeus grant, CRisP was established in 2008 based on a shared vision of decreased breast and prostate cancer mortality through individualized risk prediction and prevention. CRisP is a translational research environment at the Karolinska Institutet in Sweden, covering the fields of cancer epidemiology, next-generation sequencing, biostatistics, systems biology, pathology, surgery and quality-of-life research. Our long-term strategy to reach our vision is based on a strong research culture that nurtures the interplay between these fields, as well as building the most well-characterised cancer cohorts in the world.

Organization

Responsible person Responsibilities      
KI president Strategic and financial support      
Steering committee Strategic and prioritization decisions The steering committee consists of 11 professors from Karolinska Institutet and the Karolinska University Hospital, representing both pre-clinical and clinical departments. The steering committee is responsible for strategic decisions pertaining to recruitment, allocation of finances and communication.    
Scientific Advisory Board Research and strategy advice The scientific advisory board consists of international experts within the field of breast and prostate cancer research. The board is responsible for providing unbiased strategic advise on primarily research questions.    
Junior management Tactical communication The junior management team consists of junior researchers in CRisP. The team is responsible for the tactical questions pertaining to internal communication and prioritization. A member of the team participates in all steering committee meetings.    
CRisP members Proposals on projects, communication and prioritizations The CRisP members consists of all researchers, admin and technical personnel that are involved in the research projects in CRisP. All members are encouraged to provide suggestions for new projects and communication strategies through annual retreats, workshops and seminars.    

The steering committee

Professor/senior physician

Henrik Grönberg

E-mail: Henrik.Gronberg@ki.se

Professor, senior

Sven Cnattingius

E-mail: Sven.Cnattingius@ki.se

Senior researcher

Lars Egevad

Phone: +46-(0)8-517 754 92
Organizational unit: Research Group Egevad, Lars
E-mail: Lars.Egevad@ki.se

Professor/senior physician

Jan Frisell

Phone: +46-(0)8-517 709 15
Organizational unit: Breast surgery
E-mail: Jan.Frisell@ki.se

Professor/senior physician

N Peter Wiklund

Organizational unit: Urology
E-mail: Peter.Wiklund@ki.se

Professor

Yvonne Brandberg

Phone: +46-(0)72-513 51 55
Organizational unit: Department of Oncology-Pathology (OnkPat), K7
E-mail: Yvonne.Brandberg@ki.se

Associated

Jan Adolfsson

E-mail: Jan.Adolfsson@ki.se

Professor

Kamila Czene

Phone: +46-(0)8-524 861 44
Organizational unit: Department of Medical Epidemiology and Biostatistics (MEB), C8
E-mail: Kamila.Czene@ki.se

Professor

Per Hall

Organizational unit: Department of Medical Epidemiology and Biostatistics (MEB), C8
E-mail: Per.Hall@ki.se

Senior lecturer

Keith Humphreys

Phone: +46-(0)8-524 868 87
Organizational unit: Department of Medical Epidemiology and Biostatistics (MEB), C8
E-mail: Keith.Humphreys@ki.se

Överläkare, Verksamhetschef

Karin Leifland

Phone: +46-(0)8-616 35 33
Cell phone: +46-(0)765-69 67 11
E-mail: karin.horstmann-leifland@sodersjukhuset.se
Address: Södersjukhuset AB

More about the sponsors

The Swedish Research Council

The Swedish Research Council is a government agency that provides funding for basic research of the highest scientific quality in all disciplinary domains. Besides research funding, the agency works with strategy, analysis, and research communication.

CRisP is financed by the Swedish Research Council through a Linnaeus grant. With its Linnaeus grants the Swedish Research Council provides support for 40 research environments in different research areas. The aim of the Linnaeus grants is to enhance support for research of the highest quality that can compete internationally. It also aims to encourage universities and colleges to prioritize research fields and to allocate funding for them.

Märit and Hans Rausing

Through a 70 million SEK donation, Märit and Hans Rausing are the major sponsors of the KARMA study in CRisP. The overall objective of the project, which will be one of the most extensive breast cancer projects in the world, is to reduce the incidence of breast cancer by 40 to 50 per cent. Märit and Hans Rausing live in Wadhurst Park in England. Over the years they have donated generously to charity, particularly for the benefit of medical research. Their interest in breast cancer stems from the fact that it is a common disease and one which has struck members of their own family. Read more about the Märit and Hans Rausing initiative against breast cancer.

Stockholm County Council

The County Council is responsible for all publicly-financed healthcare and public transport in Stockholm County. The County Council is also responsible for other overall issues within the county, such as regional planning and cultural subsidies. It is one of Europe’s largest healthcare providers, offering everything from telephone advice about self-care to advanced specialist care at university hospitals. The County Council supports the STHLM3 study in CRisP where the aim is to develop new diagnostic tests for early and safe detection of prostate cancer.

The Swedish Cancer Society (Cancerfonden)

The Swedish Cancer Society is an independent non-profit organisation with the vision of finding cures for cancer. The overall aim of the Society is to achieve a higher survival rate and a reduction in the incidence of cancer. The main task is to raise and distribute money for cancer research. As the single largest financer of cancer research in Sweden, the Swedish Cancer Society essentially acts as a national research council.

The Strategic Research Programme in Cancer (StratCan)

The Strategic Research Programme in Cancer combines cancer biology with clinical oncology by bringing together top level cancer scientists from different disciplines. The overall goal is to generate new scientific discoveries that can be rapidly translated into clinical practice for the benefit of patients and society. The programme is supported by the government through the strategic initiatives.

Swedish eScience Research Centre (SeRC)

The Swedish eScience Research Centre supports the development of eScience tools for use in the CRisP projects, including KARMA and STHLM3. The SeRC flagship project "eScience for Cancer Prevention and Control" is based at the Department of Medical Epidemiology and Biostatistics. Keith Humphreys represents SeRC on the CRisP steering committee.

Research

The common theme of the projects within CRisP is to identify, characterize and evaluate markers predicting breast or prostate cancer risk. Many of the fundamental research questions and strategies are similar in these two hormone associated cancers, and by coordinating the research efforts and flow of ideas between these fields we cross-benefit our scientific and clinical networks. Additionally, a strong and widespread presence in the clinics will open up an effective communication channel to health personnel and patients alike. This is needed in order to transfer new findings in basic sciences to clinical practice.
Breast cancer accounts for 26% of all female cancers in the United States, with nearly 200,000 women diagnosed annually. The corresponding figure in Sweden is 8,000. In Sweden 1,500 women die from breast cancer yearly but there is a remarkable difference between outcomes of localized vs advanced disease, approximately 98% and 30% 5-year survival in both countries, respectively. As a result, mammography screening has been promoted on the assumption that early detection and treatment is the best way to reduce mortality from breast cancer.
Prostate cancer is the most common cancer in Sweden today and yearly almost 10,000 new cases are diagnosed. Despite the old age of onset, the morbidity and mortality of this cancer is substantial. In 2008, prostate cancer was the most common cancer death among men in Sweden with more than 2,500 deaths. The etiology of prostate cancer is largely unknown, and the few established risk factors include age, ethnicity and family history of prostate cancer. The heritability of prostate cancer is 0.42 which is the highest among all studied cancers, implying that the genetic contribution to the etiology of this cancer is substantial.

Focus

  • Breast cancer accounts for 26% of all female cancers in the United States, with nearly 200,000 women diagnosed annually. The corresponding figure in Sweden is 8,000. In Sweden 1,500 women die from breast cancer yearly but there is a remarkable difference between outcomes of localized vs advanced disease, approximately 98% and 30% 5-year survival in both countries, respectively. As a result, mammography screening has been promoted on the assumption that early detection and treatment is the best way to reduce mortality from breast cancer.
  • Prostate cancer is the most common cancer in Sweden today and yearly almost 10,000 new cases are diagnosed. Despite the old age of onset, the morbidity and mortality of this cancer is substantial. In 2008, prostate cancer was the most common cancer death among men in Sweden with more than 2,500 deaths. The etiology of prostate cancer is largely unknown, and the few established risk factors include age, ethnicity and family history of prostate cancer. The heritability of prostate cancer is 0.42 which is the highest among all studied cancers, implying that the genetic contribution to the etiology of this cancer is substantial.

Methods

  • Using the latest genomic and proteomic tools together with unique cohorts and sample repositories we map out and explore biological and environmental risk and prognostic factors for breast and prostate cancer.
  • The risk factors are compiled into panels that we evaluate using micro simulations as well as smaller retrospective and prospective research studies to identify sets that can be evaluated in larger clinical trials.
  • We conduct in-depth interviews, questionnaires and workshops to better understand how risk, prognosis and preventive measures are perceived and communicated on an individual level, both from the perspective of a patient as well as a health professional.
  • The individualized risk, prognosis and prevention measures are finally evaluated in large-scale randomized clinical trials to design robust approaches that decrease the mortality of breast and prostate cancer.

Projects

We are updating the site and will shortly add more details about the specific projects.

STHLM2 aims to find out how heredity, environment and genetic changes can be used to predict the risk of developing prostate cancer. The goal is to develop better diagnostics and treatment.

STHLM3 is based on research from STHLM2, and the aim is to develop new diagnostic methods that detect prostate cancer earlier and safer. Visit the STHLM3 website

The Karma study is about creating the world’s best-characterized breast cancer cohort. The aim is to reduce the mortality and incidence in breast cancer through translational research focusing on breast cancer prevention.

The ICAP study ICAP is a collaboration between research groups at Karolinska Institutet, Karolinska University Hospital and Wake Forest University. The goal of the project is to develop a genetic test for routine diagnostics to identify malignant non-operable cancer.
LIBRO1 The aim of the Libro-1 is to identify new and previously known risk factors that affect breast cancer risk and prognosis. The overall goal for the future is to develop models for individualized prevention and treatment.

 

GeneticsProstate cancerRegister-based research