Norwegian Colorectal Cancer Prevention study no. I

NORCCAP-I

This project is a randomized study on screening for colorectal cancer (CRC) and adenomatous polyps (potential precursor lesions for colorectal cancer). The project arose from an initiative made by the Norwegian Gastrointestinal Cancer Group (NGICG) and the Norwegian Cancer Society with funding from the Norwegian Cancer Society and the Ministry of Health and Social Affairs. The screening examinations were performed in Oslo and Telemark in 1999-2001. The first interim results from follow-up were published in June 2009. 10-year follow-up results are expected in 2014.

21,000 women and men between the age of 50 and 64, living in Oslo and Telemark, were randomly drawn from the population registry and offered a screening examination by flexible sigmoidoscopy (flexible endoscope for examination of the distal 50-60 cm of the large intestine). The rest of the population in this age range (n=79,000) constituted the control group. Half of the invitees were asked to deliver a stool sample for supplementary screening for blood in the feces (FOB-testing with an immunochemical test – FlexSure OBT®) and for research purposes to develop new stool-based screening methods. Blood samples were also drawn with a view to investigate folate-related gene polymorphisms and the risk of CRC.

So far, 49 original articles and 10 Ph.D theses have been published (of which one “twin-thesis” with two Ph.D.-candidates). Much of the research done has been of great value also to routine clinical activity. The quality assurance program in NORCCAP-I has developed further into a separate programme - Gastronet – a network for quality development in gastrointestinal endoscopy in Norway. Gastronet has become one of the national quality assurance programs of the Norwegian Directorate of Health and the official quality assurance platform for the Norwegian Gastroenterology Society.