Geir Svein Hoff

• Hoff, Geir Svein; Bernklev, Tomm; Johnsen, Lene; Reitsma, Laurens Cornelus; Sina, Dirk & Lauzike, Andromeda [Show all 13 contributors for this article] (2024). Thyroidectomy for Euthyroid Patients with Hashimoto Disease and Persistent Symptoms: An Observational, Postrandomization Study. Journal of Thyroid Research. ISSN 2090-8067. doi: 10.1155/2024/5518720. Show summary

  Background: Despite adequate hormone substitution in Hashimoto disease, some patients may have persistent symptoms with a possible autoimmune pathophysiology. A recent randomized trial (RCT) using patient-reported outcome measures as the primary endpoint showed benefit in total thyroidectomy, but at a cost of high complication rates. Objective: To verify results from the RCT in an observational study including a wider range of patients and explore means of predicting who may benefit from such surgery. Design: A total of 154 patients with Hashimoto disease, euthyroid with or without thyroid hormone substitution, and persistent Hashimoto-related symptoms were subjected to total thyroidectomy and followed for 18 months after surgery. The primary outcome was the General Health (GH) dimensional score in the Short Form-36 Health Survey (SF-36). Results: Eighteen months after surgery, a clinically significant improvement in GH was seen, similar to the findings in the previous RCT. Anti-TPO antibody titers were markedly reduced after surgery, but preoperative titers or other preoperative parameters could not predict the outcome of surgery. Three (1.9%) of 154 patients experienced permanent unilateral recurrent nerve palsy and six (3.9%) experienced hypoparathyroidism after surgery. Conclusions: Thyroidectomy had a beneficial symptom-reducing effect in euthyroid patients with Hashimoto disease and persistent symptoms. The pathophysiology of residual symptoms remains unclear, and surgical complication rates are high. If thyroidectomy is considered as a treatment option, it should be performed in dedicated centers with experienced endocrine surgeons and as part of further studies on persistent symptoms. This trial is registered with NCT-02319538.

• Juul, Frederik Emil; Cross, Amanda J.; Schoen, Robert E.; Senore, Carlo; Pinsky, Paul F. & Miller, Eric A. [Show all 17 contributors for this article] (2024). Effectiveness of Colonoscopy Screening vs Sigmoidoscopy Screening in Colorectal Cancer. JAMA Network Open. ISSN 2574-3805. 7(2). doi: 10.1001/jamanetworkopen.2024.0007. Show summary

  Importance: Randomized clinical screening trials have shown that sigmoidoscopy screening reduces colorectal cancer (CRC) incidence and mortality. Colonoscopy has largely replaced sigmoidoscopy for CRC screening, but long-term results from randomized trials on colonoscopy screening are still lacking. Objective: To estimate the additional screening benefit of colonoscopy compared with sigmoidoscopy. Design, setting, and participants: This comparative effectiveness simulation study pooled data on 358 204 men and women randomly assigned to sigmoidoscopy screening or usual care in 4 randomized sigmoidoscopy screening trials conducted in Norway, Italy, the US, and UK with inclusion periods in the years 1993 to 2001. The primary analysis of the study was conducted from January 19 to December 30, 2021. Intervention: Invitation to endoscopic screening. Main outcomes and measures: Primary outcomes were CRC incidence and mortality. Using pooled 15-year follow-up data, colonoscopy screening effectiveness was estimated assuming that the efficacy of colonoscopy in the proximal colon was similar to that observed in the distal colon in the sigmoidoscopy screening trials. The simulation model was validated using data from Norwegian participants in a colonoscopy screening trial. Results: This analysis included 358 204 individuals (181 971 women [51%]) aged 55 to 64 years at inclusion with a median follow-up time ranging from 15 to 17 years. Compared with usual care, colonoscopy prevented an estimated 50 (95% CI, 42-58) CRC cases per 100 000 person-years, corresponding to 30% incidence reduction (rate ratio, 0.70 [95% CI, 0.66-0.75]), and prevented an estimated 15 (95% CI, 11-19) CRC deaths per 100 000 person-years, corresponding to 32% mortality reduction (rate ratio, 0.68 [95% CI, 0.61-0.76]). The additional benefit of colonoscopy screening compared with sigmoidoscopy was 12 (95% CI, 10-14) fewer CRC cases and 4 (95% CI, 3-5) fewer CRC deaths per 100 000 person-years, corresponding to percentage point reductions of 6.9 (95% CI, 6.0-7.9) for CRC incidence and 7.6 (95% CI, 5.7-9.6) for CRC mortality. The number needed to switch from sigmoidoscopy to colonoscopy screening was 560 (95% CI, 486-661) to prevent 1 CRC case and 1611 (95% CI, 1275-2188) to prevent 1 CRC death. Conclusions and relevance: The findings of this comparative effectiveness study assessing long-term follow-up after CRC screening suggest that there was an additional preventive effect on CRC incidence and mortality associated with colonoscopy screening compared with sigmoidoscopy screening, but the additional preventive effect was less than what was achieved by introducing sigmoidoscopy screening where no screening existed. The results probably represent the upper limit of what may be achieved with colonoscopy screening compared with sigmoidoscopy screening.

• Nafisi, Sara; Støer, Nathalie C.; Veierød, Marit B.; Randel, Kristin Ranheim; Hoff, Geir Svein & Löfling, Lukas [Show all 8 contributors for this article] (2024). Low-dose aspirin and prevention of colorectal cancer: evidence from a nationwide registry-based cohort in Norway. American Journal of Gastroenterology. ISSN 0002-9270. doi: 10.14309/ajg.0000000000002695. Show summary

  Objectives: To examine the association between low-dose aspirin use and risk of colorectal cancer (CRC). Methods: In this nationwide cohort study, we identified individuals aged ≥50 years residing for 6 months or more in Norway in 2004-2018, and obtained data from national registers on drug prescriptions, cancer occurrence, and sociodemographic factors. Multivariable Cox regression models were used to estimate the association between low-dose aspirin use and CRC risk. Additionally, we calculated the number of CRCs potentially averted by low-dose aspirin use. Results: We included 2,186,390 individuals. During the median follow-up of 10.9 years, 579,196 (26.5%) used low-dose aspirin, and 38,577 (1.8%) were diagnosed with CRC. Current use of aspirin vs. never use was associated with lower CRC risk (hazard ratios [HR]=0.87, 95% confidence intervals [CI] 0.84-0.90). The association was more pronounced for metastatic CRC (HR=0.79; 95%CI 0.74-0.84) than regionally advanced (HR=0.89; 95%CI 0.85-0.92) and localized CRC (HR=0.93; 95%CI 0.87-1.00; Pheterogeneity=0.001). A significant trend was found between duration of current use and CRC risk: HR=0.91 (95%CI 0.86-0.95) for <3 years, HR=0.85 (0.80-0.91) for ≥3 and <5 years, and HR=0.84 (0.80-0.88) for ≥5 years of use vs. never use (Ptrend<0.001). For past use, HRs were 0.89 (95%CI 0.84-0.94) for <3 years, 0.90 (0.83-0.99) for ≥3 and <5 years, and 0.98 (0.91-1.06) for ≥5 years since last use vs. never use (Ptrend<0.001). We estimated that aspirin use averted 1073 (95%CI 818-1338) CRCs in the study period. Conclusion: In this nationwide cohort, use of low-dose aspirin was associated with a lower risk of CRC.

• Botteri, Edoardo; Peveri, Giulia; Berstad, Paula Marianna; Bagnardi, Vincenzo; Hoff, Geir Svein & Heath, Alicia K. [Show all 44 contributors for this article] (2024). Lifestyle changes in middle age and risk of cancer: evidence from the European Prospective Investigation into Cancer and Nutrition. European Journal of Epidemiology (EJE). ISSN 0393-2990. doi: 10.1007/s10654-023-01059-4. Show summary

  In this study, we aimed to provide novel evidence on the impact of changing lifestyle habits on cancer risk. In the EPIC cohort, 295,865 middle-aged participants returned a lifestyle questionnaire at baseline and during follow-up. At both timepoints, we calculated a healthy lifestyle index (HLI) score based on cigarette smoking, alcohol consumption, body mass index and physical activity. HLI ranged from 0 (most unfavourable) to 16 (most favourable). We estimated the association between HLI change and risk of lifestyle-related cancers.including cancer of the breast, lung, colorectum, stomach, liver, cervix, oesophagus, bladder, and others.using Cox regression models. We reported hazard ratios (HR) with 95% confidence intervals (CI). Median time between the two questionnaires was 5.7 years, median age at follow-up questionnaire was 59 years. After the follow-up questionnaire, we observed 14,933 lifestyle-related cancers over a median follow-up of 7.8 years. Each unit increase in the HLI score was associated with 4% lower risk of lifestyle-related cancers (HR 0.96; 95%CI 0.95.0.97). Among participants in the top HLI third at baseline (HLI > 11), those in the bottom third at follow-up (HLI . 9) had 21% higher risk of lifestyle-related cancers (HR 1.21; 95%CI 1.07.1.37) than those remaining in the top third. Among participants in the bottom HLI third at baseline, those in the top third at follow-up had 25% lower risk of lifestyle-related cancers (HR 0.75; 95%CI 0.65.0.86) than those remaining in the bottom third. These results indicate that lifestyle changes in middle age may have a significant impact on cancer risk.

• Hoff, Geir Svein; Bernklev, Tomm; Johnsen, Lene; Reitsma, Laurens Cornelus; Sina, Dirk & Lauzike, Andromeda [Show all 14 contributors for this article] (2023). Thyroidectomy for Euthyroid Patients With Hashimoto Disease and Persisting Symptoms. Annals of Internal Medicine. ISSN 0003-4819. 177(1), p. 101–103. doi: 10.7326/M23-1593.
• Birkeland, Einar Elvbakken; Ferrero, Giulio; Pardini, Barbara; Umu, Sinan Ugur; Tarallo, Sonia & Bulfamante, Sara [Show all 10 contributors for this article] (2023). Profiling small RNAs in fecal immunochemical tests: is it possible? Molecular Cancer. ISSN 1476-4598. 22:161(1), p. 1–7. doi: 10.1186/s12943-023-01869-w. Full text in Research Archive Show summary

  Fecal microRNAs represent promising molecules with potential clinical interest as non-invasive diagnostic and prognostic biomarkers. Colorectal cancer (CRC) screening based on the fecal immunochemical test (FIT) is an effective tool for prevention of cancer development. However, due to the poor sensitivity of FIT especially for premalignant lesions, there is a need for implementation of complementary tests. Improving the identification of individuals who would benefit from further investigation with colonoscopy using molecular analysis, such as miRNA profiling of FIT samples, would be ideal due to their widespread use. In the present study, we assessed the feasibility of applying small RNA sequencing to measure human miRNAs in FIT leftover buffer in samples from two European screening populations. We showed robust detection of miRNAs with profiles similar to those obtained from specimens sampled using the established protocol of RNA stabilizing buffers, or in long-term archived samples. Detected miRNAs exhibited differential abundances for CRC, advanced adenoma, and control samples that were consistent for FIT and RNA-stabilizing buffers. Interestingly, the sequencing data also allowed for concomitant evaluation of small RNA-based microbial profiles. We demonstrated that it is possible to explore the human miRNome in FIT leftover samples across populations and envision that the analysis of small RNA biomarkers can complement the FIT in large scale screening settings.

• Bresalier, Robert S.; Senore, Carlo; Young, Graeme P.; Allison, James; Benamouzig, Robert & Benton, Sally [Show all 47 contributors for this article] (2023). An efficient strategy for evaluating new non-invasive screening tests for colorectal cancer: the guiding principles. Gut. ISSN 0017-5749. 72. doi: 10.1136/gutjnl-2023-329701. Show summary

  Objective: New screening tests for colorectal cancer (CRC) are rapidly emerging. Conducting trials with mortality reduction as the end point supporting their adoption is challenging. We re-examined the principles underlying evaluation of new non-invasive tests in view of technological developments and identification of new biomarkers. Design: A formal consensus approach involving a multidisciplinary expert panel revised eight previously established principles. Results: Twelve newly stated principles emerged. Effectiveness of a new test can be evaluated by comparison with a proven comparator non-invasive test. The faecal immunochemical test is now considered the appropriate comparator, while colonoscopy remains the diagnostic standard. For a new test to be able to meet differing screening goals and regulatory requirements, flexibility to adjust its positivity threshold is desirable. A rigorous and efficient four-phased approach is proposed, commencing with small studies assessing the test's ability to discriminate between CRC and non-cancer states (phase I), followed by prospective estimation of accuracy across the continuum of neoplastic lesions in neoplasia-enriched populations (phase II). If these show promise, a provisional test positivity threshold is set before evaluation in typical screening populations. Phase III prospective studies determine single round intention-to-screen programme outcomes and confirm the test positivity threshold. Phase IV studies involve evaluation over repeated screening rounds with monitoring for missed lesions. Phases III and IV findings will provide the real-world data required to model test impact on CRC mortality and incidence. Conclusion: New non-invasive tests can be efficiently evaluated by a rigorous phased comparative approach, generating data from unbiased populations that inform predictions of their health impact.

• Bucher-Johannessen, Cecilie; Birkeland, Einar Elvbakken; Vinberg, Elina; Bemanian, Vahid; Hoff, Geir Svein & Berstad, Paula [Show all 7 contributors for this article] (2023). Long-term follow-up of colorectal cancer screening attendees identifies differences in Phascolarctobacterium spp. using 16S rRNA and metagenome sequencing. Frontiers in Oncology. ISSN 2234-943X. 13. doi: 10.3389/fonc.2023.1183039. Full text in Research Archive Show summary

  Background: The microbiome has been implicated in the initiation and progression of colorectal cancer (CRC) in cross-sectional studies. However, there is a lack of studies using prospectively collected samples. Methods: From the Norwegian Colorectal Cancer Prevention (NORCCAP) trial, we analyzed 144 archived fecal samples from participants who were diagnosed with CRC or high-risk adenoma (HRA) at screening and from participants who remained cancer-free during 17 years of follow-up. We performed 16S rRNA sequencing of all the samples and metagenome sequencing on a subset of 47 samples. Differences in taxonomy and gene content between outcome groups were assessed for alpha and beta diversity and differential abundance. Results: Diversity and composition analyses showed no significant differences between CRC, HRA, and healthy controls. Phascolarctobacterium succinatutens was more abundant in CRC compared with healthy controls in both the 16S and metagenome data. The abundance of Bifidobacterium and Lachnospiraceae spp. was associated with time to CRC diagnosis. Conclusion: Using a longitudinal study design, we identified three taxa as being potentially associated with CRC. These should be the focus of further studies of microbial changes occurring prior to CRC diagnosis.

• Nafisi, Sara; Randel, Kristin Ranheim; Støer, Nathalie Charlotte; Veierød, Marit Bragelien; Hoff, Geir Svein & Holme, Øyvind [Show all 8 contributors for this article] (2023). Association between use of low-dose aspirin and detection of colorectal polyps and cancer in a screening setting. Digestive and Liver Disease. ISSN 1590-8658. 55, p. 1126–1132. doi: 10.1016/j.dld.2023.01.156. Full text in Research Archive Show summary

  Background: The possible protective effect of aspirin on risk of colorectal cancer (CRC) is still highly debated. Methods: We used data from Bowel Cancer Screening in Norway, a trial randomizing individuals from general population, aged 50-74 years, to flexible sigmoidoscopy or faecal immunochemical test (FIT), to study the association between aspirin use and detection of CRC and two CRC precursors: adenomas and advanced serrated lesions (ASL). Prescriptions of low-dose aspirin were obtained from Norwegian prescription database. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). Results: Among 64,889 screening participants (24,159 sigmoidoscopy, 40,730 FIT), 314 (0.5%) had CRC, 6,208 (9.6%) adenoma and 659 (1.0%) ASL. Overall and short-term use (<3 years) of low-dose aspirin, versus no use, were not associated with any colorectal lesion. Long-term use (≥3 years) was associated with lower detection of CRC (overall OR 0.66, 95%CI 0.46-0.93; sigmoidoscopy: 0.56, 0.33-0.97; FIT: 0.72, 0.45-1.15), adenomas in sigmoidoscopy arm (overall OR 0.95, 95%CI 0.87-1.03; sigmoidoscopy: 0.89, 0.80-0.99; FIT: 1.03, 0.89-1.18), but not ASLs. We did not observe significant differences in the effect of aspirin according to the location of colorectal lesions. Conclusion: Our results suggest that long-term use of aspirin might have a protective effect against adenomas and colorectal cancer, but not ASLs.

• Schult, Anna Lisa; Hoff, Geir Svein; Holme, Øyvind; Botteri, Edoardo; Seip, Birgitte Karen Berggreen & Randel, Kristin Ranheim [Show all 12 contributors for this article] (2023). Colonoscopy quality improvement after initial training: A cross-sectional study of intensive short-term training. Endoscopy International Open. ISSN 2196-9736. 11(1), p. E117–E127. doi: 10.1055/a-1994-6084. Full text in Research Archive Show summary

  Background and study aims High-quality is crucial for the effectiveness of colonoscopy and can be achieved by high-quality training and verified with assessment of key performance indicators (KPIs) for colonoscopy such as cecum intubation rate (CIR), adenoma detection rate (ADR) and adequate polyp resection. Typically, trainees achieve adequate CIR after 275 procedures, but little is known about learning curves for KPIs after initial training. Methods This cross-sectional study includes work-up colonoscopies after a positive screening test with fecal occult blood testing (FIT) or sigmoidoscopy, performed by either trainees after 300 training colonoscopies or by consultants. Outcome measures were KPIs. We assessed inter-endoscopist variation in trainees and learning curves for trainees as a group. We also compared KPIs for trainees and consultants as a group. Results Data from 6,655 colonoscopies performed by 21 trainees and 921 colonoscopies performed by 17 consultants were included. Most trainees achieved target standards for main KPIs. With time, trainees shortened cecum intubation time and withdrawal time without decreasing their ADR, reduced the proportion of painful colonoscopies, and increased the adequate polyp resection rate (all P < 0.01). Compared to consultants, trainees had higher CIR (97.7 % vs. 96.3 %, P = 0.02), ADR after positive FIT (57.6 % vs. 50.3 %, P < 0.01), and proximal ADR after sigmoidoscopy screening (41.1 % vs. 29.8 %; P < 0.01), higher adequate polyp resection rate (94.9 % vs. 93.1 %, P = 0.01) and fewer serious adverse events (0.65 % vs. 1.41 %, P = 0.02). Conclusions Trainees performed high-quality colonoscopies and achieved international target standards. Several KPIs continuously improved after initial training. Trainees outperformed consultants on several KPIs.

• Botteri, Edoardo; Peveri, Giulia; Berstad, Paula; Bagnardi, Vincenzo; Chen, Sairah Lai Fa & Sandanger, Torkjel M [Show all 43 contributors for this article] (2022). Changes in Lifestyle and Risk of Colorectal Cancer in the European Prospective Investigation Into Cancer and Nutrition. American Journal of Gastroenterology. ISSN 0002-9270. 118(4), p. 702–711. doi: 10.14309/ajg.0000000000002065. Show summary

  Introduction: We investigated the impact of changes in lifestyle habits on colorectal cancer (CRC) risk in a multi-country European cohort. Methods: We used baseline and follow-up questionnaire data from the EPIC cohort to assess changes in lifestyle habits and their associations with CRC development. We calculated a healthy lifestyle index (HLI) score based on smoking status, alcohol consumption, body mass index and physical activity collected at the two timepoints. HLI ranged from 0 (most unfavourable) to 16 (most favourable). We estimated the association between HLI changes and CRC risk using Cox regression models and reported hazard ratios (HR) with 95% confidence intervals (CI). Results: Among 295,865 participants, 2,799 CRC cases were observed over a median of 7.8 years. Median time between questionnaires was 5.7 years. Each unit increase in HLI from the baseline to the follow-up assessment was associated with a statistically significant 3% lower CRC risk. Among participants in the top tertile at baseline (HLI>11), those in the bottom tertile at follow-up (HLI≤9) had a higher CRC risk (HR 1.34; 95%CI 1.02-1.75) than those remaining in the top tertile. Among individuals in the bottom tertile at baseline, those in the top tertile at follow-up had a lower risk (HR 0.77; 95%CI 0.59-1.00) than those remaining in the bottom tertile. Discussion: Improving adherence to a healthy lifestyle was inversely associated with CRC risk, while worsening adherence was positively associated with CRC risk. These results justify and support recommendations for healthy lifestyle changes and healthy lifestyle maintenance for CRC prevention.

• Kirkøen, Benedicte; Berstad, Paula; Hoff, Geir; Bernklev, Tomm; Randel, Kristin Ranheim & Holme, Øyvind [Show all 9 contributors for this article] (2022). Type and Severity of Mental Illness and Participation in Colorectal Cancer Screening. American Journal of Preventive Medicine. ISSN 0749-3797. 64(1), p. 76–85. doi: 10.1016/j.amepre.2022.08.011. Full text in Research Archive Show summary

  Introduction: The effectiveness of colorectal cancer screening programs depends on the participation rate. This study examined the association between type and severity of mental illness and colorectal cancer screening participation. Methods: Between 2012 and 2017, a total of 46,919 individuals were invited to sigmoidoscopy screening in Norway, and 70,019 were invited to fecal immunochemical testing. In 2022, logistic regression was used to evaluate the association between the use of antipsychotics, anxiolytics, hypnotics, and antidepressants in the year preceding the screening invitation and screening participation, adjusted for demographic and socioeconomic factors. Defined daily doses of individual drugs were used to assess dose‒response relationships. Results: Overall, 19.2% (24.8% of women, 13.4% of men) of all invitees used at least 1 psychotropic medication. Nonparticipation in the 2 arms combined was associated with the use of anxiolytics (60.7% in users vs 43.2% in nonusers; OR=1.53; 95% CI=1.45, 1.62) and antipsychotics (64.3% vs 43.8%; OR=1.41; 95% CI=1.30, 1.53) and increased with higher doses for both drugs. Hypnotics and antidepressants were only weakly associated with nonparticipation in higher doses. Participation rates were 57.3%, 52.3%, 42.9%, and 35.4% in those prescribed 0, 1, 2, and 3-4 classes of psychotropic medications, respectively. The associations between the use of psychotropic medications and nonparticipation were similar for the 2 screening tests. Conclusions: These findings show significant disparities in colorectal cancer screening participation for individuals with mental illness, independent of the screening method. Moreover, screening participation varied depending on the type and severity of mental illness. Targeted interventions are warranted to ensure that people with mental illness are supported to access the benefits of colorectal cancer screening.

• Bretthauer, Michael; Løberg, Magnus; Wieszczy, Paulina; Kalager, Mette; Emilsson, Louise & Garborg, Kjetil Kjeldstad [Show all 21 contributors for this article] (2022). Effect of Colonoscopy Screening on Risks of Colorectal Cancer and Related Death. New England Journal of Medicine. ISSN 0028-4793. 387(17), p. 1547–1556. doi: 10.1056/NEJMoa2208375. Full text in Research Archive Show summary

  Background: Although colonoscopy is widely used as a screening test to detect colorectal cancer, its effect on the risks of colorectal cancer and related death is unclear. Methods: We performed a pragmatic, randomized trial involving presumptively healthy men and women 55 to 64 years of age drawn from population registries in Poland, Norway, Sweden, and the Netherlands between 2009 and 2014. The participants were randomly assigned in a 1:2 ratio to either receive an invitation to undergo a single screening colonoscopy (the invited group) or to receive no invitation or screening (the usual-care group). The primary end points were the risks of colorectal cancer and related death, and the secondary end point was death from any cause. Results: Follow-up data were available for 84,585 participants in Poland, Norway, and Sweden - 28,220 in the invited group, 11,843 of whom (42.0%) underwent screening, and 56,365 in the usual-care group. A total of 15 participants had major bleeding after polyp removal. No perforations or screening-related deaths occurred within 30 days after colonoscopy. During a median follow-up of 10 years, 259 cases of colorectal cancer were diagnosed in the invited group as compared with 622 cases in the usual-care group. In intention-to-screen analyses, the risk of colorectal cancer at 10 years was 0.98% in the invited group and 1.20% in the usual-care group, a risk reduction of 18% (risk ratio, 0.82; 95% confidence interval [CI], 0.70 to 0.93). The risk of death from colorectal cancer was 0.28% in the invited group and 0.31% in the usual-care group (risk ratio, 0.90; 95% CI, 0.64 to 1.16). The number needed to invite to undergo screening to prevent one case of colorectal cancer was 455 (95% CI, 270 to 1429). The risk of death from any cause was 11.03% in the invited group and 11.04% in the usual-care group (risk ratio, 0.99; 95% CI, 0.96 to 1.04). Conclusions: In this randomized trial, the risk of colorectal cancer at 10 years was lower among participants who were invited to undergo screening colonoscopy than among those who were assigned to no screening. (Funded by the Research Council of Norway and others; NordICC ClinicalTrials.gov number, NCT00883792.).

• Juul, Frederik Emil; Cross, Amanda J.; Schoen, Robert E.; Senore, Carlo; Pinsky, Paul & Miller, Eric [Show all 17 contributors for this article] (2022). 15-Year Benefits of Sigmoidoscopy Screening on Colorectal Cancer Incidence and Mortality : A Pooled Analysis of Randomized Trials. Annals of Internal Medicine. ISSN 0003-4819. 175(11), p. 1525–1533. doi: 10.7326/M22-0835. Show summary

  Background: The effectiveness of screening for colorectal cancer (CRC) by sex and age in randomized trials is uncertain. Objective: To evaluate the 15-year effect of sigmoidoscopy screening on CRC incidence and mortality. Design: Pooled analysis of 4 large-scale randomized trials of sigmoidoscopy screening. Setting: Norway, the United States, the United Kingdom, and Italy. Participants: Women and men aged 55 to 64 years at enrollment. Intervention: Sigmoidoscopy screening. Measurements: Primary end points were cumulative incidence rate ratio (IRR) and mortality rate ratio (MRR) and rate differences after 15 years of follow-up comparing screening versus usual care in intention-to-treat analyses. Stratified analyses were done by sex, cancer site, and age at screening. Results: Analyses comprised 274 952 persons (50.7% women), 137 493 in the screening and 137 459 in the usual care group. Screening attendance was 58% to 84%. After 15 years, the rate difference for CRC incidence was 0.51 cases (95% CI, 0.40 to 0.63 cases) per 100 persons and the IRR was 0.79 (CI, 0.75 to 0.83). The rate difference for CRC mortality was 0.13 deaths (CI, 0.07 to 0.19 deaths) per 100 persons, and the MRR was 0.80 (CI, 0.72 to 0.88). Women had less benefit from screening than men for CRC incidence (IRR for women, 0.84 [CI, 0.77 to 0.91]; IRR for men, 0.75 [CI, 0.70 to 0.81]; P = 0.032 for difference) and mortality (MRR for women, 0.91 [CI, 0.77 to 1.17]; MRR for men, 0.73 [CI, 0.64 to 0.83]; P = 0.025 for difference). There was no statistically significant difference in screening effect between persons aged 55 to 59 years and those aged 60 to 64 years. Limitation: Data from the U.K. trial were less granular because of privacy regulations. Conclusion: This pooled analysis of all large randomized trials of sigmoidoscopy screening demonstrates a significant and sustained effect of sigmoidoscopy on CRC incidence and mortality for 15 years.

• Kværner, Ane Sørlie; Birkeland, Einar Elvbakken; Vinberg, Elina; Hoff, Geir; Hjartåker, Anette & Rounge, Trine Ballestad [Show all 7 contributors for this article] (2022). Associations of red and processed meat intake with screen-detected colorectal lesions. British Journal of Nutrition. ISSN 0007-1145. p. 1–36. doi: 10.1017/S0007114522002860. Full text in Research Archive Show summary

  Limited data exist regarding the role of meat consumption in early-stage colorectal carcinogenesis. We examined associations of red and processed meat intake with screen-detected colorectal lesions in immunochemical fecal occult blood test (FIT)-positive participants, enrolled in the Norwegian CRCbiome study during 2017-2021, aged 55-77 years. Absolute and energy-adjusted intakes of red and processed meat (combined and individually) were assessed using a validated, semiquantitative food frequency questionnaire. Associations between meat intake and screen-detected colorectal lesions were examined using multinomial logistic regression analyses with adjustment for key covariates. Of 1,162 participants with available dietary data, 319 (27%) presented with advanced colorectal lesions at colonoscopy. High vs low energy-adjusted intakes of red and processed meat combined, as well as red meat alone, were borderline to significantly positively associated with advanced colorectal lesions (ORs (95% CIs) of 1.24 (0.98, 1.57) and 1.34 (1.07, 1.69), respectively). A significant dose-response-relationship was also observed for absolute intake levels (OR (95% CI) of 1.32 (1.09, 1.60) per 100 g/day increase in red and processed meat). For processed meat, no association was observed between energy-adjusted intakes and advanced colorectal lesions. A significant positive association was, however, observed for the small proportion of participants (10%) with absolute intake levels ≥100 vs <50 g/day (OR (95% CI) of 1.19 (1.09, 1.31)). In summary, high intakes of red and processed meat were associated with presence of advanced colorectal lesions at colonoscopy in FIT-positive participants. The study demonstrates a potential role of using dietary data to improve the performance of FIT-based screening.

• Berthelsen, Mona; Berstad, Paula; Randel, Kristin Ranheim; Hoff, Geir; Natvig, Erik & Holme, Øyvind [Show all 7 contributors for this article] (2022). The impact of driving time on participation in colorectal cancer screening with sigmoidoscopy and faecal immunochemical blood test. Cancer Epidemiology. ISSN 1877-7821. 80. doi: 10.1016/j.canep.2022.102244. Full text in Research Archive Show summary

  Background: High participation rates are important for a colorectal cancer (CRC) screening programme to be effective. Having a long travelling distance to screening centres may impede participation. Methods: We analysed the association between driving time from home address to screening centre and participation among individuals invited to screening with faecal immunochemical test (FIT) (n = 68,624) or sigmoidoscopy (n = 46,076) in a randomized trial in Norway in 2012-17. Two screening centres were involved. We fitted multiple logistic regression models, adjusted for demographic, socioeconomic and health characteristics, and reported odds ratios (OR) with 95% confidence intervals (CI). Results: Participation rates were 58.9 % (n = 40,445) for FIT and 51.9 % (n = 23,911) for sigmoidoscopy. In sigmoidoscopy, participation was 56.9 % and 47.9 % in those living < 20 and > 60 min by car from the screening centres, respectively. For each 10 min driving time increase, OR for participating in sigmoidoscopy screening was 0.93 (95 % CI 0.91-0.95). There was a significant difference between the two screening centres (p-value for heterogeneity <0.001). Participation in FIT screening were 61.2 % and 57.1 % in those with < 20 and > 60 min driving time, respectively, and the OR was 0.98 (95 % CI 0.96-0.99) for each 10 min increase (heterogeneity between screening methods, P-value <0.001). Among those with a positive FIT, compliance to colonoscopy was higher in those living < 20 compared to > 60 min from the centres (95.1 % vs. 92.9 %, respectively, OR 0.86; 95 % CI 0.77-0.93 for each 10 min increase). Conclusions: Driving time to screening centre was a significant predictor of participation, mainly in sigmoidoscopy. There were local differences in the impact of driving time on participation. Driving time also affected compliance to colonoscopy after a positive FIT. When planning a CRC screening programme, one should consider offering people living far from screening sites special assistance to facilitate their participation.

• 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 Show summary

  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.

• Pedersen, Ina Borgenheim; Rawa-Goleblewska, Anna; Calderwood, Audrey H.; Brix, Lone D.; Grode, Louise B. & Botteri, Edoardo [Show all 17 contributors for this article] (2022). Complete Polyp Resection with Cold versus Hot snare Polypectomy for Polyps sized 4-9 mm: A randomized controlled trial. Endoscopy. ISSN 0013-726X. 54(10), p. 961–969. doi: 10.1055/a-1734-7952. Show summary

  Background: Endoscopic screening with polypectomy reduces the incidence of colorectal cancer (CRC). Incomplete polyp removal may attenuate the effect of screening. This randomized trial compared cold snare polypectomy (CSP) with hot snare polypectomy (HSP) in terms of complete polyp resection. Methods: We included patients ≥ 40 years of age at eight hospitals in four countries who had at least one non-pedunculated polyp of 4-9 mm detected at colonoscopy. Patients were randomized 1:1 to CSP or HSP. Biopsies from the resection margins were obtained systematically after polypectomy in both groups. We hypothesized that CSP would be non-inferior to HSP, with a non-inferiority margin of 5 %. Logistic regression models were fitted to identify the factors explaining incomplete resection. Results: 425 patients, with 601 polyps, randomized to either CSP or HSP were included in the analysis. Of 318 polyps removed by CSP and 283 polyps removed by HSP, 34 (10.7 %) and 21 (7.4 %) were incompletely resected, respectively, with an adjusted risk difference of 3.2 % (95 %CI -1.4 % to 7.8 %). There was no difference between the groups in terms of post-polypectomy bleeding, perforation, or abdominal pain. Independent risk factors for incomplete removal were serrated histology (odds ratio [OR] 3.96; 95 %CI 1.63 to 9.66) and hyperplastic histology (OR 2.52; 95 %CI 1.30 to 4.86) in adjusted analyses. Conclusion: In this randomized trial, non-inferiority for CSP could not be demonstrated. Polyps with serrated histology are more prone to incomplete resection compared with adenomas. CSP can be used safely for small polyps in routine colonoscopy practice.

• Knudsen, Markus Dines; Kværner, Ane Sørlie; Botteri, Edoardo; Holme, Øyvind; Hjartåker, Anette & Song, Mingyang [Show all 10 contributors for this article] (2022). Lifestyle predictors for inconsistent participation to fecal based colorectal cancer screening. BMC Cancer. ISSN 1471-2407. 22(172). doi: 10.1186/s12885-022-09287-9. Full text in Research Archive Show summary

  Background: Consistent participation in colorectal cancer (CRC) screening with repeated fecal immunochemical test (FIT) is important for the success of the screening program. We investigated whether lifestyle risk factors for CRC were related to inconsistent participation in up to four rounds of FIT-screening. Method: We included data from 3,051 individuals who participated in up to four FIT-screening rounds and returned a lifestyle questionnaire. Using logistic regression analyses, we estimated associations between smoking habits, body mass index (BMI), physical activity, alcohol consumption, diet and a healthy lifestyle score (from least favorable 0 to most favorable 5), and inconsistent participation (i.e. not participating in all rounds of eligible FIT screening invitations). Results: Altogether 721 (24%) individuals were categorized as inconsistent participants Current smoking and BMI ≥30 kg/m2 were associated with inconsistent participation; odds ratios (ORs) and 95% confidence intervals (CIs) were 1.54 (1.21-2.95) and 1.54 (1.20-1.97), respectively. A significant trend towards inconsistent participation by a lower healthy lifestyle score was observed (p

• Schult, Anna Lisa; Botteri, Edoardo; Hoff, Geir; Holme, Øyvind; Bretthauer, Michael & Randel, Kristin Ranheim [Show all 13 contributors for this article] (2021). Women require routine opioids to prevent painful colonoscopies: a randomised controlled trial. Scandinavian Journal of Gastroenterology. ISSN 0036-5521. 56(12), p. 1480–1489. doi: 10.1080/00365521.2021.1969683. Full text in Research Archive Show summary

  Background: Women are at high risk for painful colonoscopy. Pain, but also sedation, are barriers to colorectal cancer (CRC) screening participation. In a randomised controlled trial, we compared on-demand with pre-colonoscopy opioid administration to control pain in women at CRC screening age. Methods: Women, aged 55-79 years, attending colonoscopy at two Norwegian endoscopy units were randomised 1:1:1 to (1) fentanyl on-demand, (2) fentanyl prior to colonoscopy, or (3) alfentanil on-demand. The primary endpoint was procedural pain reported by the patients on a validated four-point Likert scale and further dichotomized for the study into painful (moderate or severe pain) and non-painful (slight or no pain) colonoscopy. Secondary endpoints were: willingness to repeat colonoscopy, adverse events, cecal intubation time and rate, and post-procedure recovery time. Results: Between June 2017 and May 2020, 183 patients were included in intention-to-treat analyses in the fentanyl on-demand group, 177 in the fentanyl prior to colonoscopy group, and 179 in the alfentanil on-demand group. Fewer women receiving fentanyl prior to colonoscopy reported a painful colonoscopy compared to those who were given fentanyl on-demand (25.2% vs. 44.1%, p

• Kværner, Ane Sørlie; Birkeland, Einar Elvbakken; Bucher-Johannessen, Cecilie; Vinberg, Elina; Nordby, Jan Inge & Kangas, Harri [Show all 27 contributors for this article] (2021). The CRCbiome study: a large prospective cohort study examining the role of lifestyle and the gut microbiome in colorectal cancer screening participants. BMC Cancer. ISSN 1471-2407. 21. doi: 10.1186/s12885-021-08640-8. Full text in Research Archive
• Schult, Anna Lisa; Botteri, Edoardo; Hoff, Geir; Randel, Kristin Ranheim; Dalén, Eirin & Eskeland, Sigrun Losada [Show all 8 contributors for this article] (2021). Detection of cancers and advanced adenomas in asymptomatic participants in colorectal cancer screening: a cross-sectional study. BMJ Open. ISSN 2044-6055. 11(7). doi: 10.1136/bmjopen-2020-048183. Full text in Research Archive Show summary

  Objectives: To assess detection rates for colorectal cancer (CRC) and advanced adenomas in asymptomatic CRC screening participants and bowel symptoms in association with CRC and advanced adenoma. Design: Cross-sectional study. Setting: Two screening centres. Participants: 42 554 men and women, aged 50-74 years, participating in a randomised CRC screening trial. 36 059 participants underwent a sigmoidoscopy (and follow-up colonoscopy if positive sigmoidoscopy) and 6495 underwent a colonoscopy after a positive faecal immunochemical test (FIT). Primary and secondary outcome measures: Proportion of asymptomatic participants diagnosed with CRC or advanced adenomas. Prevalence of bowel symptoms (rectal bleeding, change in bowel habits, diarrhoea, constipation, bloating, alternating bowel habits, general symptoms, other bowel symptoms) recorded by the endoscopist and their association with CRC and advanced adenomas. Results: Among sigmoidoscopy participants, 7336 (20.3%) reported at least one symptom. 120 (60%) out of 200 individuals with screen-detected CRC and 1301 (76.5%) out of 1700 with advanced adenoma were asymptomatic. Rectal bleeding was associated with detection of CRC and advanced adenoma (OR 4.3, 95% CI 3.1 to 6.1 and 1.8, 95% CI 1.5 to 2.1, respectively), while change in bowel habits only with CRC detection (OR 3.8, 95% CI 2.4 to 6.1). Among the FIT positives, 2173 (33.5%) reported at least one symptom. Out of 299 individuals with screen-detected CRC and 1639 with advanced adenoma, 167 (55.9%) and 1 175 (71.7%) were asymptomatic, respectively. Detection of CRC was associated with rectal bleeding (OR 1.8, 95% CI 1.4 to 2.3), change in bowel habits (OR 2.2, 95% CI 1.4 to 3.5) and abdominal pain (OR 1.8, 95% CI 1.2 to 2.7). Conclusions: Some bowel symptoms increased the likelihood of being diagnosed with CRC or advanced adenoma. However, the majority of individuals with these findings were asymptomatic. Asymptomatic individuals should be encouraged to participate in CRC screening.

• Hoff, Geir; Botteri, Edoardo; Huppertz-Hauss, Gert; Kvamme, Jan-Magnus; Holme, Øyvind & Aabakken, Lars [Show all 13 contributors for this article] (2021). The effect of train-the-colonoscopy-trainer course on colonoscopy quality indicators. Endoscopy. ISSN 0013-726X. 53(12), p. 1229–1234. doi: 10.1055/a-1352-4583. Full text in Research Archive Show summary

  Background: Systematic training in colonoscopy is highly recommended; however, we have limited knowledge of the effects of "training-the-colonoscopy-trainer" (TCT) courses. Using a national quality register on colonoscopy performance, we aimed to evaluate the effects of TCT participation on defined quality indicators. Methods: This observational study compared quality indicators (pain, cecal intubation, and polyp detection) between centers participating versus not participating in a TCT course. Nonparticipating centers were assigned a pseudoparticipating year to match their participating counterparts. Results were compared between first year after and the year before TCT (pseudo)participation. Time trends up to 5 years after TCT (pseudo)participation were also compared. Generalized estimating equation models, adjusted for age, sex, and bowel cleansing, were used. Results: 11 participating and 11 nonparticipating centers contributed 18 555 and 10 730 colonoscopies, respectively. In participating centers, there was a significant increase in detection of polyps ≥ 5 mm, from 26.4 % to 29.2 % (P = 0.035), and reduction in moderate/severe pain experienced by women, from 38.2 % to 33.6 % (P = 0.043); no significant changes were found in nonparticipating centers. Over 5 years, 20 participating and 18 nonparticipating centers contributed 85 691 and 41 569 colonoscopies, respectively. In participating centers, polyp detection rate increased linearly (P = 0.003), and pain decreased linearly in women (P = 0.004). Nonparticipating centers did not show any significant time trend during the study period. Conclusions: Participation in a TCT course improved polyp detection rates and reduced pain experienced by women. These effects were maintained during a 5-year follow-up.

• 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 Show summary

  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.

• Randel, Kristin Ranheim; Schult, Anna Lisa; Botteri, Edoardo; Hoff, Geir; Bretthauer, Michael & Ursin, Giske [Show all 20 contributors for this article] (2020). Colorectal cancer screening with repeated fecal immunochemical test versus sigmoidoscopy: baseline results from a randomized trial. Gastroenterology. ISSN 0016-5085. 160(4), p. 1085–1096. doi: 10.1053/j.gastro.2020.11.037. Full text in Research Archive Show summary

  Background and aims: The comparative effectiveness of sigmoidoscopy and fecal immunochemical testing (FIT) for colorectal cancer (CRC) screening is unknown. Methods: Individuals aged 50-74 years living in South-East Norway were randomly invited between 2012 and 2019 to either once-only flexible sigmoidoscopy or FIT screening every second year. Colonoscopy was recommended after sigmoidoscopy if any polyp ≥10 mm, ≥ three adenomas, any advanced adenomas, or CRC was found or subsequent to FIT > 15 μg hemoglobin/g feces. Data for this report were obtained after complete recruitment in both groups and included two full FIT rounds and part of the third round. Outcome measures were participation, neoplasia detection, and adverse events. Age-standardized detection rates and age-adjusted odds ratios (OR) were calculated. Results: We included 139,291 individuals; 69,195 randomized to sigmoidoscopy and 70,096 to FIT. Participation rate was 52% for sigmoidoscopy, 58% in the first FIT round and 68% for three cumulative FIT rounds. Compared to sigmoidoscopy, detection rate for CRC was similar in the first FIT round (0.25% vs 0.27%, OR 0.92, 95% CI 0.75-1.13), but higher after three FIT rounds (0.49% vs 0.27%, OR 1.87, 95% CI 1.54-2.27). Advanced adenoma detection rate was lower in the first FIT round compared to sigmoidoscopy, 1.4% vs 2.4% (OR 0.57, 95% CI 0.53-0.62), but higher after three cumulative FIT rounds, 2.7% vs 2.4% (OR 1.14, 95% CI 1.05-1.23). There were 33 (0.05%) serious adverse events in the sigmoidoscopy group compared to 47 (0.07%) in the FIT group (p =.13). Conclusion: Participation was higher and more CRC and advanced adenomas were detected with repeated FIT compared to sigmoidoscopy. The risk of perforation and bleeding was comparable. Clinicaltrials.gov (NCT01538550).

• Pedersen, Ina Borgenheim; Bretthauer, Michael; Kalager, Mette; Løberg, Magnus; Hoff, Geir & Matapour, Senaria [Show all 13 contributors for this article] (2020). Incomplete endoscopic resection of colorectal polyps: a prospective quality assurance study. Endoscopy. ISSN 0013-726X. p. 1–9. doi: 10.1055/a-1243-0379.
• 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.

• Joranger, Pål; Nesbakken, Arild; Sorbye, Halfdan; Hoff, Geir; Oshaug, Arne & Aas, Eline (2019). Survival and costs of colorectal cancer treatment and effects of changing treatment strategies: a model approach. European Journal of Health Economics. ISSN 1618-7598. p. 1–14. doi: 10.1007/s10198-019-01130-6. Full text in Research Archive Show summary

  New and emerging advances in colorectal cancer (CRC) treatment combined with limited healthcare resources highlight the need for detailed decision-analytic models to evaluate costs, survival and quality-adjusted life years. The objectives of this article were to estimate the expected lifetime treatment cost of CRC for an average 70-year-old patient and to test the applicability and flexibility of a model in predicting survival and costs of changing treatment scenarios. The analyses were based on a validated semi-Markov model using data from a Norwegian observational study (2049 CRC patients) to estimate transition probabilities and the proportion resected. In addition, inputs from the Norwegian Patient Registry, guidelines, literature, and expert opinions were used to estimate resource use. We found that the expected lifetime treatment cost for a 70-year-old CRC patient was €47,300 (CRC stage I €26,630, II €38,130, III €56,800, and IV €69,890). Altered use of palliative chemotherapy would increase the costs by up to 29%. A 5% point reduction in recurrence rate for stages I-III would reduce the costs by 5.3% and increase overall survival by 8.2 months. Given the Norwegian willingness to pay threshold per QALY gained, society's willingness to pay for interventions that could result in such a reduction was on average €28,540 per CRC patient. The life years gained by CRC treatment were 6.05 years. The overall CRC treatment costs appear to be low compared to the health gain, and the use of palliative chemotherapy can have a major impact on cost. The model was found to be flexible and applicable for estimating the cost and survival of several CRC treatment scenarios.

• Bugajski, M; Wieszczy, P; Rupinski, M; Hoff, Geir; Huppertz-Hauss, Gert & Regula, J [Show all 8 contributors for this article] (2019). Effectiveness of digital feedback on patient experience and 30-day complications after screening colonoscopy: a randomized Health services study. Endoscopy International Open. ISSN 2196-9736. 7(4), p. E537–E544. doi: 10.1055/a-0830-4648.
• Hoff, Geir; Ursin, Giske; Løberg, Magnus; de Lange, Thomas; Skovlund, Eva & Holme, Øyvind (2019). Continuous development of colorectal cancer screening programs. Acta Oncologica. ISSN 0284-186X. 3(1), p. 822–823. doi: 10.1080/0284186X.2019.1588475. Full text in Research Archive
• Guldvog, Ivar; Reitsma, Laurens Cornelus; Johnsen, Lene Cathrin; Lauzike, Andromeda; Gibbs, Charlotte Christine & Carlsen, Eivind [Show all 13 contributors for this article] (2019). Thyroidectomy Versus Medical Management for Euthyroid Patients With Hashimoto Disease and Persisting Symptoms: A Randomized Trial. Annals of Internal Medicine. ISSN 0003-4819. 170(7), p. 453–464. doi: 10.7326/M18-0284. Full text in Research Archive
• Hoff, Geir; Botteri, Edoardo; Høie, Ole Ingebreth; Garborg, Kjetil Kjeldstad; Wiig, Håvard & Huppertz-Hauss, Gert [Show all 9 contributors for this article] (2019). Polyp detection rates as quality indicator in clinical versus screening colonoscopy. Endoscopy International Open. ISSN 2196-9736. 7(2). doi: 10.1055/a-0796-6477.
• Randel, Kristin Ranheim; Botteri, Edoardo; Romstad, Katrine Maria Kauczynska; Frigstad, Svein Oskar; Bretthauer, Michael & Hoff, Geir [Show all 8 contributors for this article] (2019). Effects of Oral Anticoagulants and Aspirin on Performance of Fecal Immunochemical Tests in Colorectal Cancer Screening. Gastroenterology. ISSN 0016-5085. 156(6), p. 1642–1649.e1. doi: 10.1053/j.gastro.2019.01.040.
• Hoff, Geir; de Lange, Thomas; Bretthauer, Michael; Dahler, Stein; Halvorsen, Fred-Arne & Huppertz-Hauss, Gert [Show all 12 contributors for this article] (2019). Registration bias in a clinical quality register. Endoscopy International Open. ISSN 2196-9736. 7(1), p. E90–E98. doi: 10.1055/a-0806-7006. Full text in Research Archive Show summary

  Background and aims:The quality of medical quality registers is poorly defined and lack of trust in data due to low completeness may be a major barrier against their use in quality improvement interventions. The aim of the current observational study was to explore how selective reporting may influence adverse events registered in the Norwegian quality register for colonoscopy (Gastronet). Materials and Methods:Gastronet's database includes data provided by endoscopists, nurses and patients. All outpatient colonoscopies reported to Gastronet in 2015 were included and compared to the total number of colonoscopies performed in Norway as retrieved from the National Patient Registry. Hospitals were categorized into four groups according to reporting completeness < 50 %, 50 % to 69 %, 70 % to 89 % and ≥ 90 %. The number of recorded adverse events (AEs) and procedure time were analyzed. Multivariate logistic regression models were fitted to explore independent factors for selection bias. Results: A total of 22,364 colonoscopies were reported to the National Patient Register of which 15,855 (71 %) were registered in Gastronet. Feedback was received from 11,079 patients (50 %). The frequency of AEs increased from 0.6 % in completeness group < 50 % to 1.6 % in completeness group ≥ 90 % ( P  < 0.001). Long colonoscopy procedure time was associated with low reporting completeness. Patient feedback was associated with older age, cecal intubation success and sedation-free colonoscopy. Conclusion:Incomplete registration in a colonoscopy quality register is associated with underreporting of AEs. Longer procedure time, a surrogate marker for time constraint, is associated with low completeness.

• 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
• Rounge, Trine Ballestad; Meisal, Roger; Nordby, Jan Inge; Ambur, Ole Herman; de Lange, Thomas & Hoff, Geir (2018). Evaluating gut microbiota profiles from archived fecal samples. BMC Gastroenterology. ISSN 1471-230X. 18(171). doi: 10.1186/s12876-018-0896-6. Full text in Research Archive
• Jodal, Henriette Cecilie; Løberg, Magnus; Holme, Øyvind; Adami, Hans Olov; Bretthauer, Michael & Emilsson, Louise [Show all 9 contributors for this article] (2018). Mortality from post-screening (interval) colorectal cancers is comparable to that from cancer in unscreened patients-a randomized sigmoidoscopy trial. Gastroenterology. ISSN 0016-5085. 155(6), p. 1787–1794. doi: 10.1053/j.gastro.2018.08.035.
• Pedersen, Ina Borgenheim; Løberg, Magnus; Hoff, Geir; Kalager, Mette; Bretthauer, Michael & Holme, Øyvind (2018). Polypectomy techniques among gastroenterologists in Norway – a nationwide survey. Endoscopy International Open. ISSN 2196-9736. 6(7). doi: 10.1055/a-0607-0727. Full text in Research Archive
• Pinsky, Paul F.; Løberg, Magnus; Senore, Carlo; Wooldrage, Kate; Atkin, Wendy S. & Bretthauer, Michael [Show all 12 contributors for this article] (2018). Number of Adenomas Removed and Colorectal Cancers Prevented in Randomized Trials of Flexible Sigmoidoscopy Screening. Gastroenterology. ISSN 0016-5085. 155(4), p. 1059–1068. doi: 10.1053/j.gastro.2018.06.040.
• Holme, Øyvind; Løberg, Magnus; Kalager, Mette; Bretthauer, Michael; Hernán, Miguel A. & Aas, Eline [Show all 14 contributors for this article] (2018). Long-term effectiveness of sigmoidoscopy screening on colorectal cancer incidence and mortality in women and men: A randomized trial. Annals of Internal Medicine. ISSN 0003-4819. 168(11), p. 775–782. doi: 10.7326/M17-1441. Full text in Research Archive
• Holme, Øyvind; Pedersen, Ina Borgenheim; Medhus, Asle Wilhelm; Aabakken, Lars; Glomsaker, Tom Birger & Kvamme, Jan-Magnus [Show all 14 contributors for this article] (2018). Endoscopy assistants influence the quality of colonoscopy. Endoscopy. ISSN 0013-726X. 50(9), p. 871–877. doi: 10.1055/s-0044-101706. Full text in Research Archive
• 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.
• Aas, Eline; Iversen, Tor & Hoff, Geir (2017). The effect of education on health behavior after screening for colorectal cancer. In Bolin, Kristian (Eds.), Human Capital and Health Behavior. Advances in Health Economics and Health Services Research. Emerald Group Publishing Limited. ISSN 978-1-78635-466-2. p. 207–242. doi: 10.1108/S0731-219920170000025007.
• Bugajski, Marek; Wieszczy, Paulina; Hoff, Geir; Rupinski, Maciej; Regula, Jaroslaw & Kaminski, Michal Filip (2017). Modifiable factors associated with patient-reported pain during and after screening colonoscopy. Gut. ISSN 0017-5749. 67(11), p. 1958–1964. doi: 10.1136/gutjnl-2017-313905.
• Kirkøen, Benedicte; Berstad, Paula Marianna; Botteri, Edoardo; Dalén, Eirin; Nilsen, Jens Aksel & Hoff, Geir [Show all 8 contributors for this article] (2017). Acceptability of two colorectal cancer screening tests: pain as a key determinant in sigmoidoscopy. Endoscopy. ISSN 0013-726X. 49(11), p. 1075–1086. doi: 10.1055/s-0043-117400.
• Kaminski, Michal Filip; Thomas-Gibson, Siwan; Bugajski, Marek; Bretthauer, Michael; Rees, Colin J. & Dekker, Evelien [Show all 29 contributors for this article] (2017). Performance measures for lower gastrointestinal endoscopy: a European Society of Gastrointestinal Endoscopy (ESGE) quality improvement initiative. United European Gastroenterology Journal (UEG Journal). ISSN 2050-6406. 5(3), p. 309–334. doi: 10.1177/2050640617700014.
• 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 . British Journal of Cancer. ISSN 0007-0920. 117(4), p. 461–469. doi: 10.1038/bjc.2017.189. Full text in Research Archive
• 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.
• Hoff, Geir; Holme, Øyvind; Bretthauer, Michael; Sandvei, Per; Darre-Næss, Ole & Stallemo, Asbjørn [Show all 11 contributors for this article] (2017). Cecum intubation rate as quality indicator in clinical versus screening colonoscopy. Endoscopy International Open. ISSN 2196-9736. 5(6), p. E489–E495. doi: 10.1055/s-0043-106180. Full text in Research Archive
• Hoff, Geir; de Lange, Thomas; Bretthauer, Michael; Buset, Magne; Dahler, Stein & Halvorsen, Fred-Arne [Show all 15 contributors for this article] (2017). Patient-reported adverse events after colonoscopy in Norway. Endoscopy. ISSN 0013-726X. 49(8), p. 745–753. doi: 10.1055/s-0043-105265.
• Kaminski, Michal Filip; Thomas-Gibson, Siwan; Bugajski, Marek; Bretthauer, Michael; Rees, Colin J. & Dekker, Evelien [Show all 29 contributors for this article] (2017). Performance measures for lower gastrointestinal endoscopy: a European Society of Gastrointestinal Endoscopy (ESGE) Quality Improvement Initiative. Endoscopy. ISSN 0013-726X. 49(4), p. 378–397. doi: 10.1055/s-0043-103411.
• Holme, Øyvind; Schoen, Robert E.; Senore, Carlo; Segnan, Nereo; Hoff, Geir & Løberg, Magnus [Show all 9 contributors for this article] (2017). Effectiveness of flexible sigmoidoscopy screening in men and women and different age groups: Pooled analysis of randomised trials. The BMJ. ISSN 1756-1833. 356. doi: 10.1136/bmj.i6673. Full text in Research Archive
• Huppertz-Hauss, Gert; Høivik, Marte; Jelsness-Jørgensen, Lars-Petter; Opheim, Randi; Henriksen, Magne & Høie, Ole Ingebreth [Show all 13 contributors for this article] (2017). Fatigue in a population-based cohort of patients with inflammatory bowel disease 20 years after diagnosis: The IBSEN study. Scandinavian Journal of Gastroenterology. ISSN 0036-5521. 52(3), p. 351–358. doi: 10.1080/00365521.2016.1256425.
• Lorentzen, Jon Andreas; Grzyb, Krzysztof; De Angelis, Paula; Hoff, Geir; Eide, Tor Jacob & Andresen, Per Arne (2016). Oncogene Mutations in Colorectal Polyps Identified in the Norwegian Colorectal Cancer Prevention (NORCCAP) Screening Study. Clinical medicine insights. Pathology. ISSN 1179-5557. 9(1), p. 19–28. doi: 10.4137/CPath.s40143.
• Kirkøen, Benedicte; Berstad, Paula Marianna; Botteri, Edoardo; Bernklev, Linn; El-Safadi, Badboni & Hoff, Geir [Show all 8 contributors for this article] (2016). Psychological effects of colorectal cancer screening: Participants vs individuals not invited. World Journal of Gastroenterology (WJG). ISSN 1007-9327. 22(43), p. 9631–9641. doi: 10.3748/wjg.v22.i43.9631.
• Huppertz-Hauss, Gert; Aas, Eline; Høivik, Marte; Langholz, Ebbe; Odes, Selwyn & Småstuen, Milada C [Show all 10 contributors for this article] (2016). Comparison of the Multiattribute Utility Instruments EQ-5D and SF-6D in a Europe-Wide Population-Based Cohort of Patients with Inflammatory Bowel Disease 10 Years after Diagnosis. Gastroenterology Research and Practice. ISSN 1687-6121. 2016:5023973, p. 1–9. doi: 10.1155/2016/5023973.
• Moritz, Volker; Holme, Øyvind; LeBlanc, Marissa & Hoff, Geir (2016). An explorative study from the Norwegian Quality Register Gastronet comparing self-estimated versus registered quality in colonoscopy performance. Endoscopy International Open. ISSN 2196-9736. 4(3), p. E326–332. doi: 10.1055/s-0042-100904.
• 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.
• Berstad, Paula Marianna; Botteri, Edoardo; Larsen, Inger Kristin; Løberg, Magnus; Kalager, Mette & Holme, Øyvind [Show all 8 contributors for this article] (2016). Lifestyle changes at middle age and mortality: A population-based prospective cohort study. Journal of Epidemiology and Community Health. ISSN 0143-005X. 71(1), p. 59–66. doi: 10.1136/jech-2015-206760.
• Bretthauer, Michael; Kaminski, Michal Filip; Løberg, Magnus; Zauber, Ann G.; Regula, Jaroslaw & Kuipers, Ernst J. [Show all 20 contributors for this article] (2016). Population-Based colonoscopy screening for colorectal cancer : A randomized clinical trial. JAMA Internal Medicine. ISSN 2168-6106. 176(7), p. 894–902. doi: 10.1001/jamainternmed.2016.0960.
• Holme, Øyvind; de Lange, Thomas; Stallemo, Asbjørn; Wiig, Håvard; Hasund, Audun & Dvergsnes, Katrine [Show all 12 contributors for this article] (2016). Routine vs. on-demand analgesia in colonoscopy: a randomized clinical trial. Endoscopy. ISSN 0013-726X. 48(09), p. 823–828. doi: 10.1055/s-0042-108433.
• Jover, Rodrigo; Bretthauer, Michael; Dekker, Evelien; Holme, Øyvind; Kaminski, Michal Filip & Løberg, Magnus [Show all 22 contributors for this article] (2016). Rationale and design of the European Polyp Surveillance (EPoS) trials. Endoscopy. ISSN 0013-726X. 48(6), p. 571–578. doi: 10.1055/s-0042-104116.
• Kirkøen, Benedicte; Berstad, Paula Marianna; Botteri, Edoardo; Åvitsland, Tone Lise; Ossum, Alvilde Maria & de Lange, Thomas [Show all 8 contributors for this article] (2016). Do no harm: No psychological harm from colorectal cancer screening. British Journal of Cancer. ISSN 0007-0920. 114(5), p. 497–504. doi: 10.1038/bjc.2016.14.
• Young, Graeme P.; Senore, Carlo; Mandel, Jack S.; Allison, James E.; Atkin, Wendy S. & Benamouzig, Robert [Show all 26 contributors for this article] (2016). Recommendations for a step-wise comparative approach to the evaluation of new screening tests for colorectal cancer. Cancer. ISSN 0008-543X. 122(6), p. 826–839. doi: 10.1002/cncr.29865.
• Huppertz-Hauss, Gert; Høivik, Marte; Jelsness-Jørgensen, Lars-Petter; Henriksen, Magne; Høie, Ole Ingebreth & Jahnsen, Jørgen [Show all 9 contributors for this article] (2016). Health-related quality of life in patients with inflammatory bowel disease 20 years after diagnosis: results from the IBSEN study. Inflammatory Bowel Diseases. ISSN 1078-0998. 22(7), p. 1679–1687. doi: 10.1097/MIB.0000000000000806.
• Moritz, Volker; Bretthauer, Michael; Holme, Øyvind; Fagerland, Morten; Løberg, Magnus & Glomsaker, Tom Birger [Show all 10 contributors for this article] (2016). Time trends in quality indicators of colonoscopy. United European Gastroenterology Journal (UEG Journal). ISSN 2050-6406. 4(1), p. 110–120. doi: 10.1177/2050640615570147.
• Hoff, Geir (2015). Look to Poland! Conversion from opportunistic screening to a randomized, national screening program for colorectal cancer. Endoscopy. ISSN 0013-726X. 47(12), p. 1104–1105. doi: 10.1055/s-0034-1393430.
• Huitfeldt, Anders; Kalager, Mette; Robins, James; Hoff, Geir & Hernan, Miguel A. (2015). Methods to Estimate the Comparative Effectiveness of Clinical Strategies that Administer the Same Intervention at Different Times. Current Epidemiology Reports. ISSN 2196-2995. 2(3), p. 149–161. doi: 10.1007/s40471-015-0045-5.
• Swanson, Sonja; Holme, Øyvind; Løberg, Magnus; Kalager, Mette; Bretthauer, Michael & Hoff, Geir [Show all 8 contributors for this article] (2015). Bounding the per-protocol effect in randomized trials: an application to colorectal cancer screening. Trials. ISSN 1745-6215. 16(541). doi: 10.1186/s13063-015-1056-8.
• Holme, Øyvind; Bretthauer, Michael; Eide, Tor Jacob; Løberg, Else Marit; Grzyb, Krzysztof & Løberg, Magnus [Show all 10 contributors for this article] (2015). Long-term risk of colorectal cancer in individuals with serrated polyps. Gut. ISSN 0017-5749. 64(6), p. 929–936. doi: 10.1136/gutjnl-2014-307793.
• Hoff, Geir (2015). Gastrointestinal cancer screening: Screening may release new research funding to improve health service also in routine clinics. Scandinavian Journal of Gastroenterology. ISSN 0036-5521. 50(6), p. 718–726. doi: 10.3109/00365521.2015.1011225.
• Huppertz-Hauss, Gert; Høivik, Marte; Langholz, E; Odes, Selwyn; Småstuen, Milada Cvancarova & Stockbrügger, Reinhold [Show all 9 contributors for this article] (2015). Health-related Quality of Life in Inflammatory Bowel Disease in a European-wide Population-based Cohort 10 Years After Diagnosis. Inflammatory Bowel Diseases. ISSN 1078-0998. 21(2), p. 337–344. doi: 10.1097/MIB.0000000000000272.
• Garborg, Kjetil Kjeldstad; Kaminski, Michal Filip; Lindenburger, Wolfgang; Wiig, Håvard; Hasund, Audun & Wronska, Ewa [Show all 13 contributors for this article] (2015). Water exchange versus carbon dioxide insufflation in unsedated colonoscopy: A multicenter randomized controlled trial. Endoscopy. ISSN 0013-726X. 47(3), p. 192–199. doi: 10.1055/s-0034-1390795.
• Berstad, Paula Marianna; Løberg, Magnus; Larsen, Inger Kristin; Kalager, Mette; Holme, Øyvind & Botteri, Edoardo [Show all 8 contributors for this article] (2015). Long-term lifestyle changes after colorectal cancer screening: randomised controlled trial. Gut. ISSN 0017-5749. 64(8), p. 1268–1276. doi: 10.1136/gutjnl-2014-307376.
• Joranger, Pål; Nesbakken, Arild; Hoff, Geir; Sorbye, Halfdan; Oshaug, Arne & Aas, Eline (2015). Modeling and Validating the Cost and Clinical Pathway of Colorectal Cancer. Medical decision making. ISSN 0272-989X. 35(2), p. 255–265. doi: 10.1177/0272989X14544749. Full text in Research Archive
• Holme, Øyvind; Bretthauer, Michael; Eide, Tor Jacob; Løberg, Else Marit; Grzyb, Krzysztof & Løberg, Magnus [Show all 10 contributors for this article] (2014). Long-term risk of colorectal cancer in individuals with serrated polyps. . Gut. ISSN 0017-5749. doi: 10.1136/gutjnl-2014-307793.
• Løberg, Magnus; Kalager, Mette; Holme, Øyvind; Hoff, Geir; Adami, Hans Olov & Bretthauer, Michael (2014). Long-Term Colorectal-Cancer Mortality after Adenoma Removal. New England Journal of Medicine. ISSN 0028-4793. 371(9), p. 799–807. doi: 10.1056/NEJMoa1315870.
• Hoff, Geir (2014). Colorectal cancer: consensus for CRC screening, but who addresses the controversies? Nature reviews: Gastroenterology & hepatology. ISSN 1759-5045. 11(6), p. 337–339. doi: 10.1038/nrgastro.2014.71.
• Holme, Øyvind; Løberg, Magnus; Kalager, Mette; Bretthauer, Michael; Hernan, Miguel A. & Aas, Eline [Show all 11 contributors for this article] (2014). Effect of Flexible Sigmoidoscopy Screening on Colorectal Cancer Incidence and Mortality A Randomized Clinical Trial. Journal of the American Medical Association (JAMA). ISSN 0098-7484. 312(6), p. 606–615. doi: 10.1001/jama.2014.8266.
• Hoff, Geir; Bretthauer, Michael; Garborg, Kjetil Kjeldstad & Eide, Tor Jacob (2013). New polyps, old tricks: controversy about removing bengin bowel lesions. BMJ. British Medical Journal. ISSN 0959-8146. 347. doi: 10.1136/bmj.f5843.

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• Berstad, Paula; Schult, Anna Lisa; Hoff, Geir Svein; Ursin, Giske & Randel, Kristin Ranheim (2023). Sosiale forskjeller i forprosjektet for tarmkreftscreening. Tidsskrift for Den norske legeforening. ISSN 0029-2001. 143(5). doi: 10.4045/tidsskr.22.0760.
• Avershina, Ekaterina; Birkeland, Einar Elvbakken; Berstad, Paula; Hoff, Geir Svein & Rounge, Trine Ballestad (2022). Total neoplastic polyp volume is correlated to several bacterial taxa in faecal immunochemical test-positive CRC-screening participants.
• Avershina, Ekaterina; Birkeland, Einar Elvbakken; Berstad, Paula; Hoff, Geir Svein & Rounge, Trine Ballestad (2022). Total neoplastic polyp volume is correlated to several bacterial taxa in faecal immunochemical test-positive CRC-screening participants.
• Birkeland, Einar Elvbakken; Kværner, Ane Sørlie; Istvan, Paula; Bermanian, Vahid; Bucher-Johannessen, Cecilie & Avershina, Ekaterina [Show all 9 contributors for this article] (2022). The microbiome in fecal immunochemical tests from colorectal cancer screening participants – can it be used as a screening biomarker?
• Hoff, Geir; Botteri, Edoardo; Berstad, Paula & Randel, Kristin Ranheim (2022). Norway – a retarded country close to 20 years since EU recommended colorectal cancer screening? A failure or a success? Norsk Epidemiologi. ISSN 0803-2491. 30(1-2), p. 83–86. doi: 10.5324/nje.v30i1-2.4982. Full text in Research Archive
• Kværner, Ane Sørlie; Knudsen, Markus Dines; Hjartåker, Anette; Henriksen, Hege; Blomhoff, Rune & Hoff, Geir Svein [Show all 9 contributors for this article] (2021). Kost, livsstil og tarmscreening. Norsk tidsskrift for ernæring (NTFE). ISSN 1503-5034.
• Hoff, Geir (2021). Quality assurance in colonoscopy: Is case mix a problem? Endoscopy. ISSN 0013-726X. doi: 10.1055/a-1690-6488.
• Holme, Øyvind; Løberg, Magnus Bjørson; Kalager, Mette; Bretthauer, Michael & Hoff, Geir (2018). In response. Annals of Internal Medicine. ISSN 0003-4819. 169(9), p. 663–664. doi: 10.7326/L18-0512.
• Løberg, Magnus; Kalager, Mette & Hoff, Geir (2018). Tailoring the message with selective reporting. European Journal of Epidemiology (EJE). ISSN 0393-2990. doi: 10.1007/s10654-018-0416-6.
• Hoff, Geir; de Lange, Thomas & Ursin, Giske (2017). Optimalisering gjennom randomisering. Tidsskrift for Den norske legeforening. ISSN 0029-2001. 137(20), p. 1578–1578. doi: 10.4045/tidsskr.17.0876.
• Jodal, Henriette Cecilie; Løberg, Magnus; Adami, Hans Olov; Bretthauer, Michael; Hoff, Geir & Kalager, Mette (2016). Interval Colorectal Cancers after Screening - More Aggressive than Clinical Cancers?
• Bretthauer, Michael; Kaminski, Michal Filip; Hassan, Cecare; Kalager, Mette; Holme, Øyvind & Hoff, Geir [Show all 10 contributors for this article] (2016). America, We Are Confused: The Updated U.S. Preventive Services Task Force Recommendation on Colorectal Cancer Screening. Annals of Internal Medicine. ISSN 0003-4819. 166(2), p. 139–140. doi: 10.7326/M16-1805.
• Holme, Øyvind; Hoff, Geir & Løberg, Magnus (2016). Colorectal cancer screening. Journal of the American Medical Association (JAMA). ISSN 0098-7484. 316(16), p. 1714–1714. doi: 10.1001/jama.2016.13846.
• Bretthauer, Michael; Kalager, Mette; Adami, Hans Olov & Hoff, Geir (2016). Who Is for CO2? Slow Adoption of Carbon Dioxide Insufflation in Colonoscopy. Annals of Internal Medicine. ISSN 0003-4819. 165(2), p. 145–6. doi: 10.7326/M16-0209.
• Randel, Kristin Ranheim; Schult, Anna Lisa; Botteri, Edoardo; Steen, Chloe Beate; Børmer, Ole P. & Hoff, Geir [Show all 7 contributors for this article] (2015). Bowel Cancer Screening in Norway (BCSN)-A Randomized Pilot Study Comparing Flexible Sigmoidoscopy (FS) to Fecal Immunochemical Test (FIT).
• Joranger, Pål; Nesbakken, Arild; Hoff, Geir; Sorbye, Halfdan; Oshaug, Arne & Aas, Eline (2015). Modell for å beregne overlevelse og kostnader av behandling for kolorektal cancer. Show summary

  Bakgrunn: Tykktarmskreft (CRC) er en viktig årsak til kreftdødsfall i Norge. Målet med denne studien var (i) å beskrive en kolorektal cancer (CRC) modell for å beregne behandlingskostnader og overlevelse og (ii) validere modellen. Materiale og metode: Vi brukte en semi-Markovmodell med 70 helsetilstander og tok hensyn til alder og tiden som har gått etter viktige inngrep/behandlinger. Modellparametrene var basert på data for 2049 CRC-pasienter ved Oslo universitetssykehus (OUS) (overlevelse), Norsk pasientregister (ressursbruk), publisert litteratur og ekspertvurderinger. Modellen fulgte pasienter diagnostisert for CRC ved en alder av 70 år og til død. Resultater: Modellen ble validert for ”face-”, intern-, ”cross”-, og ekstern validitet. Valideringene viste tilfredsstillende samsvar med andre modeller og empiriske estimater for både kostnader og overlevelse (ingen forutgående kalibrering av modellen). I en ”cross”-validering av ti års total overlevelse avvek modellens estimat med 11,5 dager (0,38 måned) sammenlignet med OUS data. Kostnadsestimatene fra vår modell var 0,3% lavere enn estimater fra en irsk modell (3,0, 1,3, -3,6 og 1,2% lavere i en irsk modell for henholdsvis TNM- stadium I, II, III og IV). I en ekstern validering sammenlignet vi relativ overlevelse estimert av modellen med pasientdata fra Kreftregisteret som inneholder et komplett sett med data for CRC pasienter i Norge. Modellen predikerte 3,9% høyere relativ overlevelse enn Kreftregisterets data viser i løpet av første året, og 0,9, 5,6 og 5,6% lavere relativ overlevelse fem, ti og femten år etter diagnose. I en annen ekstern validering ble modellen sammenliknet med empirisk estimerte ("model-free") totale kostnader basert på Norsk pasientregister. Justert for forskjeller i forutsetninger var modellens anslag 3,1% høyere enn de empirisk estimerte. Konklusjoner: CRC-modellen predikerte på en god måte overlevelse og kostnader for de ulike TNM-stadiene, og vil kunne være valid mht å estimere helsemessige og ressursmessige konsekvenser av CRC-behandling.

• de Lange, Thomas; Jørgensen, Anita; Børmer, Ole P.; Sandvei, Per; Steen, Chloe Beate & Ursin, Giske [Show all 7 contributors for this article] (2014). COLORECTAL CANCER SCREENING PILOT IN NORWAY - COMPARATIVE EFFECTIVENESS RESEARCH OF FLEXIBLE SIGMOIDOSCOPY (FS) AND FECAL IMMUNOCHEMICAL TEST(FIT).
• Ursin, Giske; Jørgensen, Anita; Børmer, Ole P.; de Lange, Thomas; Sandvei, Per & Thorjussen, Christian Bernhard Holth [Show all 7 contributors for this article] (2014). Colorectal cancer screening pilot: Comparative effectiveness research using two screening modalities.
• Joranger, Pål; Nesbakken, Arild; Hoff, Geir; Sorbye, Halfdan; Oshaug, Arne & Aas, Eline (2014). Development and validation of a Norwegian model for colorectal cancer.
• Hoff, Geir; Bretthauer, Michael; Garborg, Kjetil Kjeldstad & Eide, Tor Jacob (2014). Konsensusbaserte retningslinjer kan hindre nødvendig forskning :. Tidsskrift for Den norske legeforening. ISSN 0029-2001. 134(2), p. 148–149. doi: 10.4045/tidsskr.13.1313.

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