The Nordic-European Initiative on Colorectal Cancer
Project leader: Michael Bretthauer (PI), Hans-Olov Adami (Chairman of Scientific Advisory Committee)
Main financing: Federal funds from Norway, Poland, the Netherlands, and from the Nordic Cancer Union. In Sweden, financial support has been received from the Swedish Cancer Society and from AFA.
Population-based programs for colorectal cancer screening are now increasingly implemented in many western countries. Some of them are based on fecal occult blood testing (FOBT). Although the benefit of such screening has been documented in several clinical trials the magnitude of mortality reduction is modest partly due to low compliance, the specificity is low (which generates substantial costs for follow-up) and precursor lesions cannot be detected. Consequently, colonoscopy screening is now more widely promoted although the benefit has never been documented in a randomized trial. Therefore, such a trial was initiated around 2007 and is now well under way with participation from Norway, Poland, the Netherlands and Sweden. Initiated from MEB, the scientific secretariat is now located at the University of Oslo. We are approaching the target of involving 15,000 individuals who have undergone once in a life-time colonoscopy and include a population-based control group of about 60,000 individuals with no intervention. A baseline paper will be produced as soon as enrolment is closed, probably towards the end of 2014. Subsequent follow-up will continue for at least 15 years with incidence of and mortality from colorectal cancer as the main end-points. For now, this is the only ongoing large-scale randomized trial of colonoscopy compared with no intervention.
Hans-Olov Adami (Sweden), Michael Bretthauer (Norway), Jaroslaw Regula (Poland), Ernst Kuipers (the Netherlands), Ann Zauber (US), Miguel Hernan (US).
The NordICC Study: rationale and design of a randomized trial on colonoscopy screening for colorectal cancer.
Endoscopy 2012 Jul;44(7):695-702