Colorectal cancer screening could reduce mortality by over 40%
Karolinska Institutet
People who take part in screening for colorectal cancer may have as much as 43 per cent lower risk of dying from the disease, according to new estimates published in JAMA Network Open by researchers at Karolinska Institutet and Umeå University in Sweden. These findings are based on up to 14 years of follow-up data from the Stockholm–Gotland screening programme.
Colorectal cancer is one of the most common forms of cancer, with a favourable prognosis if detected early. Universal screening has been introduced throughout Sweden, meaning testing is offered to people aged 60–74 every two years. Participants are sent a screening kit to their home address and asked to provide a stool sample, which is analysed for small amounts of blood that are not visible to the naked eye. If blood is detected, further investigation is offered, usually in the form of a colonoscopy.
New study shows greater effectiveness
Stockholm and Gotland were early adopters, introducing routine screening as early as 2008. Researchers at Karolinska Institutet and Umeå University have now followed these individuals for up to 14 years to investigate the impact of screening on mortality rates.
“A previous evaluation of the programme showed that those who received an invitation to screening had a 14 per cent lower risk of dying from the disease,” says Johannes Blom, senior consultant and associate professor at the Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, and the study’s corresponding author. “We have now been able to show that the mortality is significantly lower than that among those who actually take part in the screening.”
One-third do not take part in screening
The researchers compared those who were invited to screening between 2008 and 2012 with a control group who were either invited later or not at all. They used a statistical method to account for factors that could distort the results, such as some people in the control group being given the opportunity to participate later on, and some invited individuals not participating.
When these factors were taken into account, an invitation to screening was associated with a 26 per cent lower risk of dying from colorectal cancer, while active participation was associated with a 43 per cent lower risk.
“Although screening is offered free of charge and the test is simple to carry out, around a third of people do not submit a sample,” says Johannes Blom. “Our study highlights the importance of taking part in colorectal cancer screening, and shows that it can actually save lives.”
Over 376,000 study participants
The study included 376,511 people, and during the follow-up period, 1,668 deaths from colorectal cancer were recorded. Some of the study’s strengths include the large study population, the long follow-up period and the use of Swedish health registers. However, the researchers emphasise that the results are based on statistical adjustments for various types of bias, meaning that some uncertainties remain.
The study was funded by the Swedish Cancer Society, the Swedish Research Council and Region Stockholm. The researchers state that they have no conflicts of interest.
Publication: “Fecal Occult Blood Screening Outcomes Adjusted for Contamination Bias and Nonadherence”, Johannes Blom, Lennarth Nyström, Håkan Jonsson, JAMA Network Open, online 20 August 2026, doi: 10.1001/jamanetworkopen.2026.29856.
Journal
JAMA Network Open
Method of Research
Observational study
Subject of Research
People
Article Title
Fecal Occult Blood Screening Outcomes Adjusted for Contamination Bias and Nonadherence
Article Publication Date
20-Aug-2026
In cancer clinical trials, federal and industry sponsors play complementary roles
New research details the vital, unique role federal support plays in cancer clinical research
A comparative study of the cancer clinical trial portfolios supported by federal funding versus industry funding reveals they have distinct, interdependent roles in cancer research.
The work, “Federal and Industry Sponsorship in US Cancer Clinical Trials,” is published online August 20thby JAMA Oncology.
The analysis found that, whereas industry trials were more likely to examine single-agent treatments, federally supported trials were more likely to focus on non-treatment interventions, diagnostics, health services research, cancer prevention, screening, or supportive care.
Federally funded trials were also more likely to study multimodality treatment regimens or treatment de-escalation strategies, or to address the needs of patients with rare or pediatric cancers.
Further, federally sponsored trials were more commonly phase II trials, whereas industry trials were more often very early phase I trials or later stage phase III trials.
The authors say their findings are consistent with a model in which federal and industry funders contribute complementary and essential functions to the cancer research ecosystem.
“Federally sponsored research brings much of the basic science discovery, trial infrastructure and early efficacy studies, while industry leads in late-stage determinative trials resulting in regulatory approvals,” said lead author Joseph M. Unger, PhD, a biostatistician and health services researcher with SWOG Cancer Research Network and professor in the Public Health Sciences Division at Fred Hutch Cancer Center. “Federally sponsored trials may then test combinations of newly approved drugs with each other or with different treatment approaches such as surgery or radiation, extending therapeutic discovery.”
Unger led a team that analyzed data from thousands of cancer trials registered in the ClinicalTrials.gov database from 2008 through 2024. The team identified interventional studies that had opened at one or more U.S. sites.
Trials were classified as federally sponsored if their lead sponsor was a federal agency, such as the National Institutes of Health. Trials with a pharmaceutical or biotech company as lead sponsor were coded as industry trials.
Among 11,681 trials that met the researchers’ criteria, 9,569 (81.9 percent) were industry sponsored. Overall, about 90 percent of all trials had cancer treatment as their primary purpose.
Among the most marked differences between the two trial portfolios, federally supported trials were much more likely than industry trials to investigate
- dose de-escalation approaches, which ask whether a drug or other intervention can be taken less frequently, for less time, or at a lower dose without compromising patient outcomes;
- regimens combining multiple modes of treatment – drug treatment followed by surgery followed by radiation therapy, for example;
- non-drug interventions, such as surgery, transplant, or behavioral interventions.
Federal trials were also considerably more likely than industry trials to study childhood cancers or rare cancers (cancers with fewer than 40,000 U.S. diagnoses per year), although the distance between federal and industry sponsors on rare cancer trials has shrunk over the time period studied.
Although they serve a unique and vital role, federally sponsored trials represent a much smaller share of the overall U.S. trial portfolio than industry-sponsored trials; compared to federally supported trials, about 9 out of 10 participants enroll in industry-sponsored trials.
Given the increasing dominance of industry in cancer clinical research and its core interest in conducting single-agent drug trials, the authors express concern that many research questions important for improving patient care but not commercially attractive may go unanswered.
The work was supported by the Public Health Sciences Division of Fred Hutch Cancer Center and The Hope Foundation for Cancer Research.
In addition to Dr. Unger, contributors to the work include Hong Xiao, PhD, and Michael L. LeBlanc, Ph.D. – both at the SWOG Statistics and Data Management Center and the Fred Hutch Cancer Center – and Dawn L. Hershman, MD, MS, of Columbia University Irving Medical Center.
SWOG Cancer Research Network is part of the National Cancer Institute's National Clinical Trials Network and the NCI Community Oncology Research Program. SWOG has more than 20,000 members in 46 states and seven other countries who design and conduct clinical trials and translational research to improve the lives of people with cancer. SWOG trials have directly led to FDA approval of 15 cancer drug regimens, changed more than 100 standards of cancer care, and saved more than 5 million years of human life. Learn more at swog.org.
“Federal and Industry Sponsorship in US Cancer Clinical Trials.” Unger JM, et al. JAMA Oncol, published online Aug 20, 2026. https://doi.org/10.1001/jamaoncol.2026.3026.
Journal
JAMA Oncology
Method of Research
Data/statistical analysis
Subject of Research
Not applicable
Article Title
Federal and Industry Sponsorship in US Cancer Clinical Trials
Article Publication Date
20-Aug-2026
No comments:
Post a Comment