Academic interests
- Lifestyle and nutrition
- Colorectal cancer screening
- Use of screening for lifestyle interventions
- Personalized colorectal cancer screening
Background
Education
- University of Oslo (Norway), PhD, 2017.
- University of Copenhagen (Denmark), MsC in human nutrition, 2012.
- University of Copenhagen and Technical University of Denmark (Denmark), BsC in food sciences, 2010.
Positions held
- 2020 - : Visiting postdoc fellow, Department of epidemiology, Harvard T.H. Chan School of Public Health, USA,
- 2019-2022: Postdoc fellow, Section for Colorectal Cancer Screening, Cancer Registry of Norway and Department of Transplantation Medicine, Division of Surgery, Inflammatory Diseases and Transplantation, Norwegian PSC Research Center, Oslo University Hospital, Norway
- 2018: Scientific advisor, Section for Colorectal Cancer Screening, Cancer Registry of Norway, Norway
- 2014-2017: PhD student, Section for Colorectal Cancer Screening, Cancer Registry of Norway and Telemark Hospital HF, Norway
- 2013-2014: Research assistant, Section for nutritional epidemiology, University of Oslo, Norway
- 2012-2013: Research assistant, Danish Cancer Society, Denmark
Partners
- Cancer Registry of Norway
- Harvard T.H. Chan School of Public Health
Tags:
Personalized colorectal cancer screening,
Use of screening for lifestyle interventions,
Lifestyle and nutrition
Publications
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Kværner, Ane Sørlie; Andersen, Astrid Riseth; Henriksen, Hege Berg; Knudsen, Markus Dines; Johansen, Anne Marte Wetting & Hjartåker, Anette
[Show all 13 contributors for this article]
(2023).
Associations of the 2018 World Cancer Research Fund/American Institute of Cancer Research (WCRF/AICR) cancer prevention recommendations with stages of colorectal carcinogenesis.
Cancer Medicine.
ISSN 2045-7634.
12(13),
p. 14806–14819.
doi:
10.1002/cam4.6119.
Full text in Research Archive
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Background: While adherence to cancer prevention recommendations is linked to lower risk of colorectal cancer (CRC), few have studied associations across the entire spectrum of colorectal carcinogenesis. Here, we studied the relationship of the standardized 2018 World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) Score for cancer prevention recommendations with detection of colorectal lesions in a screening setting. As a secondary objective, we examined to what extent the recommendations were being followed in an external cohort of CRC patients.
Methods: Adherence to the seven-point 2018 WCRF/AICR Score was measured in screening participants receiving a positive fecal immunochemical test and in CRC patients participating in an intervention study. Dietary intake, body fatness and physical activity were assessed using self-administered questionnaires. Multinomial logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for screen-detected lesions.
Results: Of 1486 screening participants, 548 were free from adenomas, 524 had non-advanced adenomas, 349 had advanced lesions and 65 had CRC. Adherence to the 2018 WCRF/AICR Score was inversely associated with advanced lesions; OR 0.82 (95% CI 0.71, 0.94) per score point, but not with CRC. Of the seven individual components included in the score, alcohol, and BMI seemed to be the most influential. Of the 430 CRC patients included in the external cohort, the greatest potential for lifestyle improvement was seen for the recommendations concerning alcohol and red and processed meat, where 10% and 2% fully adhered, respectively.
Conclusions: Adherence to the 2018 WCRF/AICR Score was associated with lower probability of screen-detected advanced precancerous lesions, but not CRC. Although some components of the score seemed to be more influential than others (i.e., alcohol and BMI), taking a holistic approach to cancer prevention is likely the best way to prevent the occurrence of precancerous colorectal lesions.
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Knudsen, Markus Dines; Wang, Kai; Berstad, Paula; Polychronidis, Georgios; Vithayathil, Mathew & Song, Mingyang
(2023).
Use of surveillance colonoscopy among individuals with removal of high-risk polyps according to the US Multi-Society Task Force recommendations.
Cancer.
ISSN 0008-543X.
129(9),
p. 1394–1401.
doi:
10.1002/cncr.34692.
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Henriksen, Hege; Knudsen, Markus Dines; Carlsen, Monica Hauger; Hjartåker, Anette & Blomhoff, Rune
(2022).
A Short Digital Food Frequency Questionnaire (DIGIKOST-FFQ) Assessing Dietary Intake and Other Lifestyle Factors Among Norwegians: Qualitative Evaluation With Focus Group Interviews and Usability Testing.
JMIR Formative Research.
ISSN 2561-326X.
6(11).
doi:
10.2196/35933.
Full text in Research Archive
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Wang, Liang; Knudsen, Markus Dines; Lo, Chun-Han; Wang, Kai; He, Mingming & Polychronidis, Georgios
[Show all 14 contributors for this article]
(2022).
Adherence to a healthy lifestyle in relation to colorectal cancer incidence and all-cause mortality after endoscopic polypectomy: A prospective study in three U.S. cohorts.
International Journal of Cancer.
ISSN 0020-7136.
151,
p. 1523–1534.
doi:
10.1002/ijc.34176.
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Botteri, Edoardo; Hoff, Geir; Randel, Kristin Ranheim; Holme, Øyvind; de Lange, Thomas & Bernklev, Tomm
[Show all 16 contributors for this article]
(2022).
Characteristics of nonparticipants in a randomised colorectal cancer screening trial comparing sigmoidoscopy and faecal immunochemical testing.
International Journal of Cancer.
ISSN 0020-7136.
151(3),
p. 361–371.
doi:
10.1002/ijc.34025.
Full text in Research Archive
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Public health systems should guarantee universal access to health care services, including cancer screening. We assessed whether certain population subgroups were underrepresented among participants in colorectal cancer screening with sigmoidoscopy and faecal immunochemical testing (FIT). Between 2012 and 2019, about 140 000 individuals aged 50 to 74 years were randomly invited to once-only sigmoidoscopy or first round of FIT screening. Our study included 46 919 individuals invited to sigmoidoscopy and 70 019 to FIT between 2012 and 2017. We used logistic regression models to evaluate if demographic and socioeconomic factors and use of certain drugs were associated with participation. Twenty-four thousand one hundred and fifty-nine (51.5%) individuals attended sigmoidoscopy and 40 931 (58.5%) FIT screening. Male gender, young age, low education and income, being retired or unemployed, living alone, being an immigrant, long driving time to screening centre, and use of antidiabetic and psychotropic drugs were associated with low participation in both screening groups. Many of these factors also predicted low acceptance of colonoscopy after positive FIT. While male gender, young age and living alone were more strongly associated with nonparticipation in FIT than sigmoidoscopy, low education and income, being retired or immigrant and long driving time were more strongly associated with nonparticipation in sigmoidoscopy than FIT. In conclusion, participation was lower in sigmoidoscopy than FIT. Predictors of nonparticipation were similar between arms. However, low socioeconomic status, being an immigrant and long driving time affected participation more in sigmoidoscopy screening, suggesting that FIT may guarantee more equal access to screening services than sigmoidoscopy.
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Knudsen, Markus Dines; Botteri, Edoardo; Holme, Øyvind; Hjartåker, Anette; Song, Mingyang & Thiis-Evensen, Espen
[Show all 11 contributors for this article]
(2020).
Association between lifestyle and site-specific advanced colorectal lesions in screening with faecal immunochemical test and sigmoidoscopy.
Digestive and Liver Disease.
ISSN 1590-8658.
p. 1–7.
doi:
10.1016/j.dld.2020.11.021.
Full text in Research Archive
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Background: Lifestyle factors may help to identify individuals at high-risk for colorectal cancer (CRC).
Aims: To examine the association between lifestyle, referral for follow-up colonoscopy and proximal neoplasia detection in CRC screening.
Methods: In this observational study, 14,832 individuals aged 50-74 years were invited to faecal immunochemical test (FIT) or sigmoidoscopy screening. Advanced lesions (AL), including advanced adenomas, advanced serrated lesions and CRC were divided according to location: distal-only, or proximal with or without distal AL. We collected information on smoking habit, body mass index and alcohol intake through a questionnaire.
Results: Out of 3,318 FIT and 2,988 sigmoidoscopy participants, 516 (16%) and 338 (11%), respectively, were referred for follow-up colonoscopy after a positive screening test. Two-hundred-and-fifty-six (4%) had distal-only and 119 (2%) proximal AL. In FIT participants, obesity and high alcohol intake were associated with proximal AL; odds ratio (95% confidence interval) 2.68 (1.36-5.26) and 2.16 (1.08-4.30), respectively. In sigmoidoscopy participants, current smoking was associated with proximal AL; 4.58 (2.24-9.38), and current smoking and obesity were associated with referral for colonoscopy; 2.80 (2.02-3.89) and 1.42 (1.01-2.00), respectively.
Conclusion: Current smoking, obesity and high alcohol intake were associated with screen-detected proximal colorectal AL. Current smoking and obesity were associated with referral for follow-up colonoscopy in sigmoidoscopy screening.
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He, Ming-ming; Fang, Zhe; Hang, Dong; Wang, Feng; Polychronidis, Georgios & Wang, Liang
[Show all 13 contributors for this article]
(2020).
Circulating liver function markers and colorectal cancer risk: A prospective cohort study in the UK Biobank.
International Journal of Cancer.
ISSN 0020-7136.
doi:
10.1002/ijc.33351.
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Knudsen, Markus Dines; Hoff, Geir; Tidemann-Andersen, Ida; Ekeberg Bodin, Gry; Øvervold, Sissel & Berstad, Paula
(2020).
Public Awareness and Perceptions of Colorectal Cancer
Prevention: a Cross-Sectional Survey.
Journal of Cancer Education.
ISSN 0885-8195.
doi:
10.1007/s13187-020-01721-5.
Show summary
We aimed to investigate awareness of colorectal cancer (CRC) lifestyle risk factors, willingness to participate in CRC screening, and preferences concerning channels for information on CRC prevention in the general population, including the target age of the upcoming Norwegian national CRC screening program. The present study was a cross-sectional online survey of adults aged 39 to 55 years registered as Kantar Web Panel respondents in Norway. The survey included demographic characteristics, multiple choice knowledge questions of lifestyle risk factors for CRC, attitudes towards CRC screening, and preferred channels for receiving information on CRC prevention. Of 4375 participants invited, 2007 (46%) answered the survey. The average number of correctly identified lifestyle risk factors for CRC was 7.3 of ten. Women were significantly more likely than men, and those with university or college education more likely than those with lower education to correctly identify at least eight risk factors (odds ratio, OR = 1.53, 95% confidence interval, CI 1.25-1.87, and OR = 1.51, 95% CI 1.23-1.86, respectively). The number of correctly identified risk factors was positively associated with willingness to participate in CRC screening (P for trend < 0.001). The national public work force and the Norwegian Cancer Society were selected by 76% and 69% of the participants, respectively, to be trustworthy sources of information on CRC prevention. Awareness of CRC risk factors was associated with willingness to participate in CRC screening. The national public work force and Cancer Society can be generally accepted sources of CRC preventive information.
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Knudsen, Markus Dines; Hjartåker, Anette; Robb, Kathryn A.; de Lange, Thomas; Hoff, Geir & Berstad, Paula Marianna
(2018).
Improving Cancer Preventive Behaviors: A Randomized Trial of Tailored Lifestyle Feedback in Colorectal Cancer Screening.
Cancer Epidemiology, Biomarkers and Prevention.
ISSN 1055-9965.
27(12),
p. 1442–1449.
doi:
10.1158/1055-9965.EPI-18-0268.
Full text in Research Archive
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Knudsen, Markus Dines; Hjartåker, Anette; Olsen, Marie Kristin Ek; Hoff, Geir; de Lange, Thomas & Bernklev, Tomm
[Show all 7 contributors for this article]
(2018).
Changes in health behavior 1 year after testing negative at a colorectal cancer screening: a randomized-controlled study.
European Journal of Cancer Prevention.
ISSN 0959-8278.
27(4),
p. 316–322.
doi:
10.1097/CEJ.0000000000000328.
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de Lange, Thomas; Randel, Kristin Ranheim; Schult, Anna Lisa; Knudsen, Markus Dines; Kirkøen, Benedicte & Botteri, Edoardo
[Show all 11 contributors for this article]
(2017).
Sigmoidoskopi og testing for blod i avføringen - En sammenlignende screeningstudie.
Tidsskrift for Den norske legeforening.
ISSN 0029-2001.
137(10),
p. 727–730.
doi:
10.4045/tidsskr.16.1031.
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Knudsen, Markus Dines; de Lange, Thomas; Botteri, Edoardo; Nguyen, Dung-Hong; Evensen, Helge & Steen, Chloe Beate
[Show all 10 contributors for this article]
(2016).
Favorable lifestyle before diagnosis associated with lower risk of screen-detected advanced colorectal neoplasia.
World Journal of Gastroenterology (WJG).
ISSN 1007-9327.
22(27),
p. 6276–6286.
doi:
10.3748/wjg.v22.i27.6276.
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Hjartåker, Anette; Knudsen, Markus Dines; Tretli, Steinar & Weiderpass, Elisabete
(2014).
Consumption of berries, fruits and vegetables and mortality among 10,000 Norwegian men followed for four decades.
European Journal of Nutrition.
ISSN 1436-6207.
doi:
10.1007/s00394-014-0741-9.
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Knudsen, Markus Dines; Wang, Kai; Wang, Liang; Polychronidis, Georgios; Berstad, Paula & Hjartåker, Anette
[Show all 10 contributors for this article]
(2024).
Colorectal cancer incidence and mortality after negative colonoscopy screening according to individuals’ risk profiles .
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Henriksen, Hege Berg; Carlsen, Monica Hauger; Knudsen, Markus Dines; Hjartåker, Anette & Blomhoff, Rune
(2023).
Digikost: A digital application for diet and lifestyle assessment and benchmarking against national guidelines. .
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Knudsen, Markus Dines; Kai, Wang; Wang, Liang; Polychronidis, Georgios; Berstad, Paula & Hjartåker, Anette
[Show all 10 contributors for this article]
(2023).
LONG-TERM INCIDENCE AND MORTALITY OF COLORECTAL CANCER AFTER
NEGATIVE COLONOSCOPY SCREENING IN THREE U.S POPULATION-BASED COHORTS.
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Hang, Dong; Knudsen, Markus Dines & Song, Mingyang
(2023).
Moving Toward Personalized Colorectal Cancer Follow-Up Care.
JAMA Oncology.
ISSN 2374-2437.
10(1),
p. 29–31.
doi:
10.1001/jamaoncol.2023.5072.
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Kirkøen, Benedicte & Knudsen, Markus Dines
(2018).
Hva med alle dem som ikke har tarmkreft? -.
Aftenposten Viten.
ISSN 2464-3033.
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Knudsen, Markus Dines; Berstad, Paula Marianna; Hjartåker, Anette; Gulichsen, Elisabeth Haagensen; Hugin, Silje & Hoff, Geir
[Show all 9 contributors for this article]
(2017).
People discontinuing colorectal cancer screening is properly the ones benefiting the most from screening.
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Knudsen, Markus Dines; Berstad, Paula Marianna; Hjartåker, Anette; Gulichsen, Elisabeth Haagensen; Hoff, Geir & de Lange, Thomas
[Show all 8 contributors for this article]
(2017).
Lifestyle predictors for non-participation and outcome in the second round of faecal immunochemical test in colorectal cancer screening.
Norsk Epidemiologi, Supplement.
ISSN 0803-4206.
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Knudsen, Markus Dines; Hjartåker, Anette; Hoff, Geir; de Lange, Thomas; Bernklev, Tomm & Berstad, Paula Marianna
(2016).
Differences in health behavior at 1-year follow-up between attendees of two screening modalities having a negative screening test result, and controls. .
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Knudsen, Markus Dines; Lange, Thomas de; Hjartåker, Anette & Berstad, Paula Marianna
(2016).
Association between colorectal cancer screening and health behavior at one-year follow-up, a randomized control study with two screening modalities.
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Knudsen, Markus Dines; Botteri, Edoardo; Steen, Chloe Beate; Hoff, Geir; Lange, Thomas de & Bernklev, Tomm
[Show all 8 contributors for this article]
(2015).
Baseline lifestyle characteristics in participants in bowel cancer screening in Norway and in controls.
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Published
Oct. 20, 2022 3:27 PM
- Last modified
Oct. 20, 2022 3:27 PM