Effectiveness of colorectal cancer screening on colorectal cancer incidence and mortality

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Colorectal cancer (CRC) is a leading cause of cancer death in the Western world. Norway is one of the countries in the world with the highest incidence of CRC. Screening for fecal occult blood (FOBT) has been subjected to several randomized controlled tri als (RCT). Other screening modalities used for CRC screening are colonoscopy and flexible sigmoidoscopy. In Norway, there have been performed two randomized controlled trials for colorectal cancer screening during the past years, the Telemark Polyp Stud y (TPS), and the Norwegian Colorctal Cancer Prevention (NORCCAP) trial. These trials are unique because they are the only studies worldwide which are truly population-based, and long-term results are eagerly awaited internationally. The Norwegian governme nt is currently discussing approaches for CRC screening for the Norwegian population. Evidence from Norwegian trials on CRC screening are therefore highly awaited as a rationale to introduce population based CRC screening in Norway. Different European co untries have different approaches to CRC screening. Comparison of these screening tools head-to-head is necessary to be able to identify the best test for any given population. This post-doc protocol avaluates the Norwegian randomized trials of colorecta l cancer screening in its effect on CRC incidence and mortality after 10 years of follow-up by hazard analyses in the screening groups compared to tge conrol groups. Further, the study compares interval cancer rates as a proxy for effectiveness in the C Rc screening programmes in Poland, Norway and Finland, whic are using different screening tools. The high quality of cancer registry data in the three countries allows us to compare interval CRC incidence rates to evaluate the different screening approach es used in the three countries.