Joint Nordic CRC
The first phase of the Joint Nordic Colorectal Cancer project was running from 2012 to 2015. The second phase has been signed for 2016-2018 by Karolinska Institute (Sweden), University of Helsinki (Finland), Statens Serum Institute (Denmark), and Norwegian University of Science and Technology (Norway).
Summary of progress, first phase:
To assess the importance of heredity of ColoRectal Cancer (CRC), individuals with CRC were identified in each participating country and information about first, second and third degree relatives were retrieved. Coded individual records from registry linkages were sent to Denmark from Sweden and Finland for joint statistical analyses.
To discover new (and validate potential) biomarkers related to etiology of CRC, we identified a joint Nordic study base of CRC cases. The study coordinators in the Nordic countries identified a large number of different biobanks that have stated that the biobanked samples and data are accessible and that requests for samples and data will be welcomed, both in Sweden, Denmark, Finland, Norway, Estonia and Iceland. In total, these biobanks reported that they store samples from some 30000 patients with colorectal cancer. There were both samples with extracted DNA, serum or plasma, erythrocytes, granulocytes, buffy coat, mononuclear leukocytes, paraffin embedded samples and fresh frozen biopsies.
The biobanks were later approached with an application for a withdrawal of samples for genotyping of CRC. Genome-wide association studies (GWASs) have identified 30 independent CRC risk loci and in a recent Finnish study an additional 20 SNPs were associated with CRC. Samples from approximately 5700 individuals with CRC and from almost 3000 controls were actually retrieved and delivered for analysis.
While the project was ongoing, the technological possibilities advanced to the extent that whole genome sequencing (WGS) of samples became possible at reasonable price and effort. The formalities enabled such studies only in Sweden and Finland. We further selected cases with a prominent history of colorectal cancer and, as a pilot, performed WGS on 51 patients and matched controls.
For the final phase we will now focus on extracting clinical data and clinical specimens for the discovery and validation of biomarkers related to early detection (screening) and to treatment optimization (personalized medicine).