Personalizing colorectal cancer screening by lifestyle

Colorectal cancer screening reduces the incidence and mortality of cancer. However, many people need to go through the screening examination without having a cancer or precursors of cancer. Screening programmes practice “one-size fits all” approach and use only age as risk factor. This project investigates whether colorectal cancer screening can be improved by including lifestyle information from participants, personalizing screening to fit the individual’s risk profile.
Last updated: 5/20/2021


The risk of colorectal cancer is partly related to lifestyle. Smoking, high alcohol intake, physical inactivity, obesity and unhealthy diet increase the risk of getting this cancer form. Screening reduces the incidence and mortality of colorectal cancer. However, screening will lead to unnecessary examinations for many people because they do not have cancer or precursors of cancer.

A widely used screening test is a test for blood in the stool repeated every two years. Those with a positive test are invited to a colonoscopy examination of the rectum and colon, which can reveal cancer or cancer precursors.

Personalized colorectal cancer screening that takes into account the participant's risk profile, including lifestyle, will be able to reduce the number of unnecessary examinations and provide a more effective screening program. This may be less frequent tests for those at low risk, but closer follow-up and more suitable testing for those at high risk. In addition, screening can be used to improve the lifestyle among the participants, thereby reducing the risk of colorectal cancer and other lifestyle related diseases.


In this research project, we want to facilitate a better colorectal cancer screening program that is adapted to the participant's risk profile. We also want to improve the lifestyle among the participants. The five sub-projects will investigate and develop:

  1. Relationship between lifestyle factors and the detection of colorectal cancer or precursors of colorectal cancer in the third screening round with a test for blood in the stool.
  2. Association between lifestyle and the type of precursors of colorectal cancer.
  3. Together with the Department of Nutrition Research, University of Oslo, we develop an electronic questionnaire for effective assessment of the screening participants' lifestyles.
  4. Test the validity of the electronic lifestyle questionnaire.
  5. The effect of lifestyle changes on recurrence of colorectal cancer and precursors of colorectal cancer in two large American cohort studies in collaboration with Harvard University in Boston.


Knudsen MDBotteri EHolme ØHjartåker ASong MThiis-Evensen ENorvard ERSchult ALRandel KRHoff GBerstad P (2020)
Association between lifestyle and site-specific advanced colorectal lesions in screening with faecal immunochemical test and sigmoidoscopy
Dig Liver Dis, 53 (3), 353-359
DOI 10.1016/j.dld.2020.11.021PubMed 33309513