{"entity":{"id":"nordicc","kind":"trial","name":"NordICC (Nordic-European Initiative on Colorectal Cancer)","aka":[],"tldr":"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.","status":"mixed","asOf":"2026-09-10","links":[{"label":"ClinicalTrials.gov NCT00883792","url":"https://clinicaltrials.gov/study/NCT00883792"},{"label":"NordICC (NEJM 2022)","url":"https://doi.org/10.1056/NEJMoa2208375"}],"tags":[],"related":[],"cancers":["colorectal"],"sections":[],"technologies":["colorectal-screening"],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":["fit-test","screening"],"trials":[],"people":[],"bottlenecks":[],"keyPapers":["paper-nordicc-nejm-2022","paper-nordicc-lancet-2026-update"],"journals":[],"dependsOn":[],"notes":[],"nct":"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","result":"10-year colorectal cancer risk 0.98% vs 1.20% (RR 0.82) by invitation; mortality RR 0.90, not significant.","started":"2009-05","yearReported":2022,"enrolled":84585,"enrolledBasis":"analysed","enrolledNote":"ClinicalTrials.gov lists 95,000 participants (actual); the NEJM 2022 analysis covers the 84,585 participants in Poland, Norway and Sweden with follow-up data (28,220 invited, 56,365 usual care).","outcomes":[{"endpoint":"Colorectal cancer incidence at 10 years (intention to screen)","primary":true,"unit":"%","arms":[{"name":"Invited to colonoscopy","value":0.98},{"name":"Usual care","value":1.2}],"hr":0.82,"ci":[0.7,0.93],"source":"https://doi.org/10.1056/NEJMoa2208375"},{"endpoint":"Colorectal cancer death at 10 years","unit":"%","arms":[{"name":"Invited to colonoscopy","value":0.28},{"name":"Usual care","value":0.31}],"hr":0.9,"ci":[0.64,1.16],"source":"https://doi.org/10.1056/NEJMoa2208375"}]},"route":"/trials/nordicc/","neighbours":{"cancer":[{"id":"colorectal","kind":"cancer","name":"Colorectal cancer","route":"/cancers/colorectal/"},{"id":"early-onset-colorectal","kind":"cancer","name":"Early-onset colorectal cancer (under 50)","route":"/cancers/early-onset-colorectal/"}],"technology":[{"id":"colorectal-screening","kind":"technology","name":"Colorectal cancer screening (colonoscopy, FIT, stool DNA, blood)","route":"/technologies/colorectal-screening/"}],"term":[{"id":"fit-test","kind":"term","name":"Faecal immunochemical test (FIT)","route":"/terms/fit-test/"},{"id":"screening","kind":"term","name":"Screening","route":"/terms/screening/"}],"paper":[{"id":"paper-nordicc-lancet-2026-update","kind":"paper","name":"Long-term effects of colonoscopy screening on colorectal cancer incidence and mortality: a multicountry, population-based randomised controlled trial","route":"/key-papers/paper-nordicc-lancet-2026-update/"},{"id":"paper-nordicc-nejm-2022","kind":"paper","name":"NordICC: inviting people to a screening colonoscopy reduced bowel cancer, but less than expected","route":"/key-papers/paper-nordicc-nejm-2022/"}],"roadmap":[{"id":"prevention-roadmap","kind":"roadmap","name":"Cancer prevention roadmap: tobacco control and vaccines → biomarker-guided chemoprevention → interception in carriers","route":"/roadmaps/prevention-roadmap/"},{"id":"colorectal-roadmap","kind":"roadmap","name":"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","route":"/roadmaps/colorectal-roadmap/"}],"idea":[{"id":"idea-crc-screening-uptake-and-age-extension","kind":"idea","name":"Treat screening uptake, not test sensitivity, as the thing to optimise, and settle the age extension with a trial rather than a model","route":"/ideas/idea-crc-screening-uptake-and-age-extension/"}],"trial":[{"id":"minnesota-fob","kind":"trial","name":"Minnesota Colon Cancer Control Study","route":"/trials/minnesota-fob/"},{"id":"national-polyp-study","kind":"trial","name":"National Polyp Study","route":"/trials/national-polyp-study/"}]}}