RecruitingNot ApplicableNCT04967183

Polyprev: Study to Compare Fecal Immunochemical Test With Endoscopic Surveillance After Advanced Adenoma Resection in Fecal Immunochemical Test Colorectal Cancer Screening Programs.

Polyprev Study: Randomized, Multicenter, Controlled Trial Comparing Fecal Immunochemical Test With Endoscopic Surveillance After Advanced Adenoma Resection in Fecal Immunochemical Test Colorectal Cancer Screening Programs.


Sponsor

Fundacin Biomedica Galicia Sur

Enrollment

3,788 participants

Start Date

Jun 1, 2022

Study Type

INTERVENTIONAL

Conditions

Summary

Colorectal cancer (CRC) screening programs have been implemented to reduce the burden of the disease. When an advanced colonic lesions is detected, it is recommended to perform endoscopic surveillance with different intervals between explorations. Although the reduction in CRC incidence, endoscopic surveillance is producing a considerable increase in the number of colonoscopies. However, participation in CRC screening programs based on the fecal immunochemical test (FIT) could be a non inferior alternative to endoscopic surveillance. Based on this hypothesis, the research group have designed a randomized clinical trial within the population CRC screening programs to compare FIT surveillance to endoscopic surveillance in patients with advanced lesions resected.


Eligibility

Min Age: 50 YearsMax Age: 65 Years

Inclusion Criteria2

  • Individuals aged 50 to 65 years.
  • Individuals with at least one advanced adenoma (tubulovillous or villous histology, high grade dysplasia or ≥ 10mm), and / or at least three non-advanced adenomas detected and resected completely within the population-based CRC screening program.

Exclusion Criteria10

  • Personal history of CRC.
  • Colonic lesion ≥10mm resected without histological diagnosis.
  • More than 10 adenomas in baseline colonoscopy.
  • Serrated polyposis syndrome.
  • Two or more first-degree relatives with CRC.
  • Hereditary predisposition to CRC.
  • Relevant comorbidity with life expectancy inferior to 5 years.
  • Colonoscopy with incomplete mucosal examination.
  • Incomplete resection of baseline lesions.
  • Non-acceptance after reading the informed consent.

Interventions

DIAGNOSTIC_TESTAnnual FIT

Patients will be offered an annual FIT and colonoscopy will be performed if fecal hemoglobin concentration is ≥10µg / g of feces. After performing a colonoscopy the FIT will be sent to the patient: * After one year if the unscheduled colonoscopy has been incomplete or a lesion requiring endoscopic surveillance has been completely resected. * After five years if the colonoscopy has evaluated the entire mucosa, it is normal or with lesions that do not require endoscopic surveillance (1-2 non-advanced adenomas).

PROCEDUREEndoscopic surveillance.

First surveillance colonoscopy will be performed in three-year time. If an advanced adenoma or at least three non-advanced adenomas are detected, colonoscopy will be repeated after 3 years. In contrast, if colonoscopy is normal or 1-2 non-advanced adenomas are detected, colonoscopy will be repeated after 5 years.


Locations(1)

Complexo Hospitalario Universitario de Ourense

Ourense, Spain

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NCT04967183


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