# NordICC (Nordic-European Initiative on Colorectal Cancer)

Source: https://onco.cc/trials/nordicc/  
OnCo record `nordicc` (Trial). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

The first randomised trial of colonoscopy screening: being invited cut the risk of bowel cancer by about a fifth, but fewer than half of those invited attended, so the effect on deaths was small.

## Summary

84,585 people were randomised; only 42% of the invited group had a colonoscopy. In the intention-to-screen analysis at 10 years, colorectal cancer risk was 0.98% in the invited group versus 1.20% in the usual-care group (risk ratio 0.82), and colorectal cancer death 0.28% versus 0.31% (risk ratio 0.90, not significant). Adjusted per-protocol analysis estimated a 31% reduction in cancer incidence and a 50% reduction in death among those who actually attended. The trial (NEJM 2022) reframed colonoscopy as a strong test but a weak programme where participation is low, strengthening the case for FIT-based programmes.

## Fields

- Kind: Trial
- Status: mixed
- Last checked: 2026-09-10
- Registry id: NCT00883792
- Phase: 3
- Setting: Population-based randomised trial of invitation to a single screening colonoscopy versus no invitation in Poland, Norway and Sweden, adults aged 55 to 64
- Sponsor: University of Oslo and partners
- Enrolled: 84585
- Result: 10-year colorectal cancer risk 0.98% vs 1.20% (RR 0.82) by invitation; mortality RR 0.90, not significant.
- Outcomes: Colorectal cancer incidence at 10 years (intention to screen): Invited to colonoscopy 0.98% vs Usual care 1.2%, HR 0.82; Colorectal cancer death at 10 years: Invited to colonoscopy 0.28% vs Usual care 0.31%, HR 0.9

## Sources

- ClinicalTrials.gov NCT00883792: https://clinicaltrials.gov/study/NCT00883792
- NordICC (NEJM 2022): https://doi.org/10.1056/NEJMoa2208375

## Connected records

- cancers: [Colorectal cancer](https://onco.cc/cancers/colorectal/), [Early-onset colorectal cancer (under 50)](https://onco.cc/cancers/early-onset-colorectal/)
- technologies: [Colorectal cancer screening (colonoscopy, FIT, stool DNA, blood)](https://onco.cc/technologies/colorectal-screening/)
- terms: [Faecal immunochemical test (FIT)](https://onco.cc/terms/fit-test/), [Screening](https://onco.cc/terms/screening/)
- key papers: [Long-term effects of colonoscopy screening on colorectal cancer incidence and mortality: a multicountry, population-based randomised controlled trial](https://onco.cc/key-papers/paper-nordicc-lancet-2026-update/), [NordICC: inviting people to a screening colonoscopy reduced bowel cancer, but less than expected](https://onco.cc/key-papers/paper-nordicc-nejm-2022/)
- roadmaps: [Cancer prevention roadmap: tobacco control and vaccines → biomarker-guided chemoprevention → interception in carriers](https://onco.cc/roadmaps/prevention-roadmap/), [Colorectal cancer roadmap: from the adenoma-carcinoma sequence and the first screening trials to total mesorectal excision, oxaliplatin, RAS testing, immunotherapy for mismatch repair-deficient disease, ctDNA-guided treatment and organ preservation](https://onco.cc/roadmaps/colorectal-roadmap/)
- ideas: [Treat screening uptake, not test sensitivity, as the thing to optimise, and settle the age extension with a trial rather than a model](https://onco.cc/ideas/idea-crc-screening-uptake-and-age-extension/)
- trials: [Minnesota Colon Cancer Control Study](https://onco.cc/trials/minnesota-fob/), [National Polyp Study](https://onco.cc/trials/national-polyp-study/)

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