ECOPOP: Advancing Organ-Preserving Treatment and Evidence-Based Care for Early Colorectal Cancer
Colorectal cancer (CRC) is the second leading cause of cancer-related deaths in Europe. While screening programmes enable earlier detection, standard surgical treatment may be overly invasive, particularly for elderly and frail patients. Advances in flexible endoscopy now allow local tumour removal; however, robust long-term evidence comparing oncological outcomes with surgery remains limited, and reliable criteria for selecting optimal treatment strategies are still needed.
The EU-funded ECOPOP project, led by Professor Michael Bretthauer and coordinated by the University of Oslo, is carried out by an international consortium including the Oslo University Hospital, Medical University of Gdansk, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Universitaetsklinikum Hamburg-Eppendorf, Karolinska Institute, University Hospitals Leuven, Dartmouth-Hitchcock University, Humanitas University Milano, MAGIC Evidence Ecosystem Foundation, University of Basel and Hospital Clinic de Barcelona.
The project will evaluate the efficacy and safety of endoscopic resection for early-stage CRC through three randomized controlled trials. In parallel, it aims to develop criteria for identifying high-risk lesions using novel biomarkers, advanced endoscopic imaging, and AI-guided treatment algorithms. By integrating clinical outcomes research with biomarker discovery, patient preference assessment, and cost-effectiveness analyses, ECOPOP seeks to enable more personalized, less invasive, and sustainable treatment strategies.
MAGIC Evidence Ecosystem Foundation is involved in Work Package 7 (WP7) and WP 15 focusing on communication, dissemination, exploitation, and the development of trustworthy clinical practice guidelines. MAGIC ensures rigorous evidence synthesis and appraisal using systematic reviews, the GRADE framework, and structured evidence-to-decision approaches, translating evidence into clear and actionable recommendations for clinicians, patients, and policymakers. Within WP7 MAGIC will develop living guidelines that are continuously updated as new evidence emerges and disseminated through MAGICapp. In addition, MAGIC will evaluate optimal strategies for communicating and presenting evidence using mixed-methods user research, informing improvements in guideline usability and digital implementation tools.
Through this integrated approach, ECOPOP aims to generate high-quality evidence to inform future clinical practice guidelines, improve patient outcomes, and support safer, more effective, and less invasive care for early-stage colorectal cancer.
