NOCRC - Novel CRC Screening Tools Improve Survival and Cost-effectiveness

Every year, approximately 2 000 Danes die from colorectal cancer (CRC).


FOBT screening

To reduce the mortality, a screening program based on analysis for feces occult blood (FOBT) and colonoscopy will be initiated in DK January 2014 at a cost of 200 mill DKK/year.

This screening strategy has been documented to reduce mortality by 15 %.

Nevertheless, the FOBT has two major weaknesses: low patient compliance (about 50 %) and mediocre sensitivity (about 60 %), which results in around 30 % clinical sensitivity.
Consequently, 70% of the CRC cases in the screening cohort will go undetected.


Blood Based Test

From a societal perspective there is great potential in replacing the FOBT with a better test, thereby reducing mortality further and improving cost-effectiveness.

Blood based tests have much better patient acceptance than feces tests, and well performing blood markers have been reported.

However, they have not been validated in the context of operational screening programs, so the necessary evidence to justify their use has not yet been generated.

With the present interdisciplinary cancer research alliance, bringing together experts from Denmark, UK, and USA, we aim to develop and validate a high performance blood based test.
We will test the most promising existing markers, but also develop novel markers and ultra-sensitive and cost-efficient methods to quantify these.
We include a thorough health economic analysis of the cost/benefit of the new markers. The company Exiqon will be instrumental in designing, validating, and providing market access for the test.