A randomized study on colorectal cancer screening (NORCCAP)
Background
The NORCCAP project is a randomized study on screening for, and prevention of, colorectal cancer (CRC). NORCCAP was also a pilot on a possible national screening program. The project was initiated by the Norwegian Gastrointestinal Cancer Group (NGICG) and the Norwegian Cancer Society with shared funding between the Norwegian Cancer Society and the Ministry of Health and Care Services. The Cancer Registry took over the ownership of NORCCAP in 2002. The study was started and carried out under the leadership of Geir Hoff.
The screening examinations were carried out over the course of three years (1999-2001) in Oslo and Telemark. 21,000 women and men aged 50-64, 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. In line with this, blood samples were also taken. Participants have been followed over time.
Ongoing sub-project
Microbial biomarkers for colon cancer
Previous studies have shown that there is a difference in gut bacteria between healthy people and people with bowel cancer. There are few studies studies that have investigated the connection between the intestinal flora and early stages of bowel cancer. In this study, we will use samples collected in the NORCCAP study, together with 15 years of follow-up cancer data to try to find early biomarkers for bowel cancer.
NordICC - collaborative project
The NordICC (NORCCAP-II) project is similar in design to NORCCAP-I, but the screening method is an examination of the entire colon with a colonoscopy (colonoscopy), not just an examination of the lower approx. 50 cm. Due to a lack of funding, NORCCAP-II was "flagged out" in 2005 as the NordICC group (Nordic-European Initiative on Colorectal Cancer), but with coordination from Norway.
The project started with recruitment in Poland and the Netherlands, and eventually Sweden and Norway also joined. The screening phase itself was carried out as planned in the summer of 2014.
Results
So far, 66 original articles and 12 Ph.D theses have been published. 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.
NORCCAP summary report 1999-2001
