Research projects

The research projects in ColorectalScreen Norway cover a variety of different topics and aim to develop and improve the colorectal screening program.
Last updated:

Below, you can read about ongoing research projects in ColorectalScreen Norway.

Oral reminders and information about colorectal screening in native language

Non-Western immigrants have low participation in cancer screening. Information about colorectal screening in Norway is provided in Norwegian. The purpose of the study is to investigate the effect of contacting non-participating immigrants from Pakistan and Somalia via telephone, speaking Urdu and Somali, to remind them about the invitation to colorectal screening. Additionally, a reminder letter in Norwegian is sent to all those who have not participated within 6 weeks. The study hypothesis is that the intervention will increase participation among the selected immigrant groups, compared to just receiving the reminder letter.

Data collection started in 2024 and will last for approximately 12 months. Later, the study will also investigate the effect of the phone call on repeated attendance in subsequent screening rounds. The study is funded by the Norwegian Cancer Society.

The study is part of the ImmigrantScreen project. This project examines, among other things, the reasons why immigrants participate or not participate in breast and colorectal cancer screening programs.

Responsible: Paula Berstad, Bowel Screening Section, Cancer Registry.

From colonoscopy to liquid biopsy

Colorectal cancer tumors and precursors release circulating tumor DNA (ctDNA) into the bloodstream, which can be detected through a blood test. The study group in Levanger has previously identified a panel of ctDNA markers capable of detecting colorectal cancer up to two years before diagnosis. In the planned project, the aim is to test whether the panel can be used to distinguish patients with colorectal cancer from those without (precursors, other colorectal diseases, no colorectal diseases). Additionally, those diagnosed with colorectal cancer will be followed to observe how the type and amount of ctDNA vary with different subtypes of colorectal cancer and the progression of the disease. The goal of the project is in line with the intention of more personalized medicine, to evaluate the role ctDNA can play as a biomarker for early detection and characterization of colorectal cancer, as well as for treatment choices and patient follow-up.

The project plans to include all patients scheduled for colonoscopy at Levanger Hospital from the fall of 2024 for approximately 3 years and follow them in an observational study. After colonoscopy, one blood sample will be taken, and those diagnosed with colorectal cancer will undergo an additional set of blood tests in connection with later treatment/follow-up at the hospital.

Responsible: Eivor A. Laugsand, Levanger Hospital, Surgical Department, Department of Public Health and Nursing, NTNU, Trondheim.

Water colonoscopy for improved colorectal cancer screening

Serrated polyps (SP) are difficult to detect and remove. The best way to detect and remove SP is unknown. During conventional colonoscopy, the colon is distended with CO2 gas, which makes SP less visible and harder to remove. In water colonoscopy, all gas is suctioned out of the colon and replaced with water throughout the procedure. This results in less stretched colon wall. SP then float up, and detection and removal underwater are simplified. The result could be improved screening effectiveness, especially for women who are three times as likely as men to develop colorectal cancer from serrated polyps. The project also aims to investigate whether water colonoscopy increases the proportion of pain-free examinations and whether it may be more sustainable than conventional colonoscopy.

The project is planned to be conducted at Bærum Hospital, Akershus University Hospital, Ullevål Hospital, Østfold Hospital, and in the Swedish colorectal cancer screening program in Gothenburg.

Inclusion will start at Bærum Hospital in the spring of 2024 and gradually expand to the other screening centers. The project period will initially span over 3 years.

Responsible: Anna Lisa Schult, Medical Department, Bærum Hospital.

Other relevant research projects:

Ongoing PhD projects

Nadia Iqbal
Increasing access to cancer screening among immigrants.

The doctoral work is part of ImmigrantScreen. The project aims to measure the effect of providing information and invitations to breast and colorectal cancer screening in the assumed native language. The effect is measured by looking at the participation rate. In addition, the project aims to identify factors influencing immigrants' decisions to participate or not participate in the Colorectal Screening Program. Increased knowledge in this field could contribute to tailoring screening services for minorities.

Pilot study on colorectal cancer screening

The pilot project started in 2012, and 140,000 women and men aged 50-74 years (as of 01.01.2012) residing in Østfold, Akershus, and Buskerud have been invited to participate. The project is now in its final phase, and the last invitation has been sent out. You can read about the studies associated with the pilot project here.

Gut bacteria and lifestyle in bowel screening (CRCbiome)

There is a connection between gut bacteria and colorectal cancer risk. We aim to find a biomarker based on the bacterial content in stool samples and investigate the relationship between precursors of colorectal cancer, lifestyle factors, and gut bacteria. You can read more about CRCbiome here.

NORCCAP (Norwegian Colorectal Cancer Prevention)

NORCCAP is a randomized trial on bowel screening. The Cancer Registry has several active research projects studying the causes of colorectal cancer based on this data collection. Read more about NORCCAP here.