The CRCbiome study: a large prospective cohort study examining the role of lifestyle and the gut microbiome in colorectal cancer screening participants
Artikel i vetenskaplig tidskrift, 2021

Background: Colorectal cancer (CRC) screening reduces CRC incidence and mortality. However, current screening methods are either hampered by invasiveness or suboptimal performance, limiting their effectiveness as primary screening methods. To aid in the development of a non-invasive screening test with improved sensitivity and specificity, we have initiated a prospective biomarker study (CRCbiome), nested within a large randomized CRC screening trial in Norway. We aim to develop a microbiome-based classification algorithm to identify advanced colorectal lesions in screening participants testing positive for an immunochemical fecal occult blood test (FIT). We will also examine interactions with host factors, diet, lifestyle and prescription drugs. The prospective nature of the study also enables the analysis of changes in the gut microbiome following the removal of precancerous lesions.

Methods: The CRCbiome study recruits participants enrolled in the Bowel Cancer Screening in Norway (BCSN) study, a randomized trial initiated in 2012 comparing once-only sigmoidoscopy to repeated biennial FIT, where women and men aged 50–74 years at study entry are invited to participate. Since 2017, participants randomized to FIT screening with a positive test result have been invited to join the CRCbiome study. Self-reported diet, lifestyle and demographic data are collected prior to colonoscopy after the positive FIT-test (baseline). Screening data, including colonoscopy findings are obtained from the BCSN database. Fecal samples for gut microbiome analyses are collected both before and 2 and 12 months after colonoscopy. Samples are analyzed using metagenome sequencing, with taxonomy profiles, and gene and pathway content as primary measures. CRCbiome data will also be linked to national registries to obtain information on prescription histories and cancer relevant outcomes occurring during the 10 year follow-up period.

Discussion: The CRCbiome study will increase our understanding of how the gut microbiome, in combination with lifestyle and environmental factors, influences the early stages of colorectal carcinogenesis. This knowledge will be crucial to develop microbiome-based screening tools for CRC. By evaluating biomarker performance in a screening setting, using samples from the target population, the generalizability of the findings to future screening cohorts is likely to be high. Trial registration: ClinicalTrials.gov Identifier: NCT01538550.

Advanced neoplasia

Diet

Colonoscopy

Metagenomics sequencing

Gut microbiome

iFOBT

Screening

Lifestyle

FIT

Adenoma

Colorectal cancer

Prescription drugs

Biomarkers

Författare

Ane Sørlie Kværner

Cancer Registry of Norway Institute of Population-Based Cancer Research

Einar Birkeland

Cancer Registry of Norway Institute of Population-Based Cancer Research

Cecilie Bucher-Johannessen

Cancer Registry of Norway Institute of Population-Based Cancer Research

Rikshospitalet-Radiumhospitalet HF

Elina Vinberg

Cancer Registry of Norway Institute of Population-Based Cancer Research

Jan Inge Nordby

Oslo universitetssykehus

Harri Kangas

Helsingin Yliopisto

Vahid Bemanian

Akershus University Hospital

Pekka Ellonen

Helsingin Yliopisto

Edoardo Botteri

Cancer Registry of Norway Institute of Population-Based Cancer Research

Erik Natvig

Cancer Registry of Norway Institute of Population-Based Cancer Research

Torbjørn Rognes

Oslo universitetssykehus

Universitetet i Oslo

Eivind Hovig

Rikshospitalet-Radiumhospitalet HF

Universitetet i Oslo

Robert Lyle

Norwegian Institute of Public Health

Oslo universitetssykehus

Ole Herman Ambur

OsloMet – storbyuniversitetet

Akershus University Hospital

Willem M. de Vos

Wageningen University and Research

Helsingin Yliopisto

Scott Bultman

The University of North Carolina at Chapel Hill

Anette Hjartåker

Universitetet i Oslo

Rikard Landberg

Chalmers, Biologi och bioteknik, Livsmedelsvetenskap

Mingyang Song

Harvard School of Public Health

Massachusetts General Hospital

Hege Salvesen Blix

Universitetet i Oslo

Norwegian Institute of Public Health

Giske Ursin

Cancer Registry of Norway Institute of Population-Based Cancer Research

Kristin Ranheim Randel

Cancer Registry of Norway Institute of Population-Based Cancer Research

Thomas de Lange

Sahlgrenska universitetssjukhuset

Sykehuset Asker og Bærum

Göteborgs universitet

Geir Hoff

Cancer Registry of Norway Institute of Population-Based Cancer Research

Sykehuset Telemark

Øyvind Holme

Sørlandet Hospital Kristiansand

Cancer Registry of Norway Institute of Population-Based Cancer Research

Universitetet i Oslo

Paula Berstad

Cancer Registry of Norway Institute of Population-Based Cancer Research

Trine B. Rounge

Cancer Registry of Norway Institute of Population-Based Cancer Research

Universitetet i Oslo

BMC Cancer

1471-2407 (ISSN)

Vol. 21 1 930

Ämneskategorier

Allmänmedicin

Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi

Cancer och onkologi

DOI

10.1186/s12885-021-08640-8

PubMed

34407780

Mer information

Senast uppdaterat

2021-08-26