Primary prevention:
Polyacetylens falcarinol (FaOH) and falcarindiol (Fa2OH), extracted from carrots, have shown prophylactic effects in animal cancer models and human cancer-cell cultures. Furthermore we have shown the polyacetylenes to have a COX-inhibitory effect in vitro.

Ongoing and planned projects:

1: Ex vivo studies on FaOH and Fa2OH anti-inflammatory effects including COX inhibition

2: Animal studies on bioavailability, dose response, organ distribution, breast cancer models, metastasis models and more.

3: Human physiological studies on bioavailability from carrots, carrot juice, smoothies and more.

4: Carrots species, processing, storage and more.

5: Polyp prevention in patients in follow up after removal of high risk polyps and cancer.

6: Falcarinol and falcarindiol as adjuvant treatment after curative surgery for colorectal cancer.

7: Anti-inflammatory effect of FaOH and Fa2OH in screening individuals with a false positive iFOBT.

Secondary prevention:
We are investigating alternative methods for colorectal cancer screening programmes by colon camera capsule. The aim is to increase survival and decrease procedure related complications in the screening population by offering a more accurate, safe and acceptable method.

In collaboration with SDU Mærks McKinney Møller Robotic Center, we have developed new software to perform an estimation of colon cleansiness as well as polyp number, size and morphology.

Ongoing or planned projects:

1: 3-way randomized trial of different boosters and bowel cleansing procedures before colon camera capsule investigation.

2: Software development of camera capsule analytic tools for optical biopsy, polyp size estimation and automatic pattern recognition.

3: Hardware development of capsules for enhanced transit, therapeutic capability and active movement.

4: Clinical study of 3000 screened incividuals for capsule accuracy, complications, acceptability etc.

5: Camera capsule investigations (perhaps in combination with iFOBT test) use in general practice for symptomatic patients as a filter to colonoscopy.

6: Camera capsule investigations in follow up for hereditary disposition to colorectal cancer.

Tertiary prevention / Early Treatment
The large adenomas and the early cancers of the colon and rectum can potentially be treated with advanced transanal, minimal invasive, surgical procedures. Differentiation of treatment increases the demands for high quality of preoperative staging of the disease.

Ongoing projects:

1: STAR TReC is an international multicenter randomized clinical trial, where the outcome is to ensure the desease control with minimal invasive surgery in combination with radiotherapy for early rectal cancers. The aim is to characterize the patients who can avoid large surgery which has an impact on quality of life.

2: EMR/ESD vs TEM. A Randomized clinical trial to evaluate which operative method is superior when treating large adenomas and co-incident malignancies.

3: eFTR is a national multicenter study, where a new method for endoscopic Full Thickness Resection of colonic advanced neoplasia is being evaluated.

4: ePROM, Complications after colonoscopy. Society impact from patient reported outcomes after diagnostic and therapeutic colonoscopy.

5: DECT, Dual Energy CT in the staging of colorectal neoplasia.