Welcome to the Swedish part of the ESCP website! This page provides information on colorectal surgical practice and research in Sweden.
- Population: 10,596,652
- Society: Swedish Society for Colon and Rectal Surgeons. 276 members.
- ESCP members: 63
- ESCP representative: Kalle Landerholm (
This email address is being protected from spambots. You need JavaScript enabled to view it. ) - Certified colorectal surgeons: 51 passed EBSQ examination, 100+ passed a previous national examination
- National surgical journal: Svensk Kirurgi
- National examination: Two national (north and south) preparatory courses of 15 days over 3 years is continuously held for the EBSQ Coloproctology examination.
Minimally invasive surgery
Minimally invasive surgery for colorectal cancer was adopted early in Sweden and quickly gained widespread acceptance. Since 2016, it is recommended as the technique of choice by the national guidelines for colorectal cancer. In 2024, 85% of patients with rectal cancer were operated by minimal invasive surgery, the vast majority of which by robotic technique. In the same year, 74% of patients with colon cancer were treated with minimally invasive surgery, a majority of them by conventional laparoscopy.
Centralization
Advanced and less common procedures and care are centralized in Sweden as decided by the national government. Within the colorectal field cytoreductive surgery/HIPEC, pelvic exenteration, anal cancer treatment, intestinal failure, reconstructive IBD surgery and reconstructive surgery of obstetric injuries are all centralized to 2–4 university hospitals. Rectal cancer surgery is performed at most regional hospitals.
Research
Swedish research in the colorectal field is renowned for its high quality. This reputation ows a lot to our national registries including general health care registries held by the National Board of Health and Welfare as well as the specific colorectal registries SCRCR (Swedish Colorectal Cancer registry) and SWIBREG (Swedish Inflammatory Bowel Disease Registry). Also contributing is a generally positive attitude towards participation in multicentre studies and a strong commitment to thorough data reporting.
A substantial portion of the research is derived from PhD theses. In Sweden, a PhD thesis typically consists of a series of individual scientific articles along with a comprehensive review of the topic. The dissertation act involves a public defence of the thesis, where an opponent challenges the respondent. The quality of the defence is then assessed by an examination committee.
Swedish theses in colorectal surgery >
Current research
ALASCCA (Adjuvant low dose aspirin in colorectal cancer)
25 Swedish hospitals and eight hospitals from other parts of Scandinavia are participating in a study to determine whether three years of treatment with 160mg of acetylsalicylic acid can improve the rate of disease-free survival for patients with acquired mutation in the PI3K-signalling pathway. The first results of this study were presented at ESCP in Paris and printed in NEJM 2025.
WoW (Watch and Wait) study
Patients who achieve a complete response after neoadjuvant treatment for rectal cancer are offered participation in this study. If they consent, surgery is postponed, and they are enrolled in a rigorous follow-up program. Surgery is only performed if the disease recurs. The results of this study are expected to be published soon. Additionally, a second WoW study has already started.
The ACBC study (Acute Colon resection versus Bridge to Colon surgery with stent or stoma)
This prospective cohort study compares acute colon resection versus bridge to colon surgery with the use of stent or stoma in patients requiring acute intervention due to colon obstruction caused by colon cancer, regardless of tumour location. Patients are actively recruited in 19 Swedish hospitals.
CRUISE (Colectomy reconstruction for ulcerative colitis in Sweden and England)
This multicentre prospective study compares ileorectal anastomosis and ileal pouch-anal anastomosis after colectomy in patients with ulcerative colitis. The study focuses on patient satisfaction, quality of life, functional outcomes and complications. It is conducted in collaboration with St Mark's, London.
EFFIPEC (Efficacy of hyperthermic intra peritoneal chemotherapy)
This multicentre randomised controlled trial compares standard HIPEC treatment after cytoreductive surgery to an intensified HIPEC treatment regimen.
SELSA (Selective defunctioning stoma approach in low anterior resection for rectal cancer)
This multicentre Nordic trial is an observational study with a nested randomised controlled trial where patients with a low risk of anastomotic leak are randomised to no defunctioning stoma (experimental arm) or defunctioning stoma (standard arm). The study also includes a translational substudy. This study won the ESCP New Trials Prize in Vilnius 2023 and is ESCP-badged.
TRIOCOL (Third line of advanced therapies or colectomy in ulcerative colitis)
This multicentre prospective study compares next line of advanced therapies (biologicals, JAK-inhibitor, S1P-receptor modulators or later drugs) and laparoscopic colectomy in patients with ulcerative colitis who have failed two or more advanced therapies, and who are eligible for either surgery or next line of advanced therapies. The study focuses on patient satisfaction, quality of life, functional outcomes and complications. It is conducted in collaboration with England as well as potential centers in Norway, Italy and the Netherlands.