Digital Public Defence: Pasquale Klepp

MD Pasquale Klepp at Institute of Clinical Medicine will be defending the thesis "Colorectal cancer in Ulcerative Colitis. A prospective study of clinical and biological markers in population based cohorts" for the degree of PhD (Philosophiae Doctor).

The public defence will be held as a video conference over Zoom.

The defence will follow regular procedure as far as possible, hence it will be open to the public and the audience can ask ex auditorio questions when invited to do so.

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Due to copyright reasons, an electronic copy of the thesis must be ordered from the faculty. In order for the faculty to have time to process the order, it must be received by the faculty no later than 2 days prior to the public defence. Orders received later than 2 days before the defence will not be processed. Inquiries regarding the thesis after the public defence must be addressed to the candidate.

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Adjudication committee

  • First opponent: Professor Tine Jess, Statens Serum Institut, Denmark
  • Second opponent: Professor Arne Sandvik, Norwegian University of Science and Technology, Trondheim
  • Third member and chair of the evaluation committee: Associate Professor Øyvind Holme, Institute of Clinical Medicine, University of Oslo

Chair of defence

Professor Emeritus Tom Øresland, Institute of Clinical Medicine, University of Oslo

Principal supervisor

Associate Professor Stephan Brackmann, Institute of Clinical Medicine, University of Oslo


A significant number of IBD patients still develop colitis associated colorectal cancer (CACRC). Guidelines, therefore, recommend colonoscopic surveillance at intervals based on a patient´s individual risk determined by clinical risk factors. To improve the detection of lesions, high definition (HD) colonoscopy or dye-enhanced colonoscopy, chromoendoscopy (CE) are advised. However, the current risk of CA-CRC in Norway is unknown. Moreover, colonoscopic surveillance is not systematically implemented, and CE is not widely applied for the surveillance of IBD patients in Norway.

The purpose of the study was to examine the overall risk of CA-CRC and the association to clinical risk factors in a Norwegian population-based inception cohort of ulcerative colitis (UC) patients. Furthermore, the implementation of CE in everyday practice in a community hospital, and the efficacy of non-invasive multitarget stool DNA tumour markers (MTsDNA). 

The study found that although surveillance colonoscopy was not systematically performed, the risk of CA-CRC in UC was low and comparable to the risk of CRC in the background population of Norway. Chromoendoscopy appeared to be of value for dysplasia surveillance of UC in a community hospital setting. The yield of non-targeted biopsies was negligible. The MT-sDNA panel detected CA-CRC. Sensitivity for sub-centimeter colorectal neoplasms in IBD patients, appeared similar to that observed in the non-IBD population.

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Published Sep. 3, 2021 10:42 AM - Last modified Jan. 24, 2022 1:12 PM