Precision of Optical Diagnosis in Polyps Between 5-15 mm and Its Implications on Surveillance. A Prospective, Multicenter Study. (POPS)

May 16, 2022 updated by: EDUARDO REDONDO CEREZO, MD, PhD, University Hospital Virgen de las Nieves
This study evaluates the ability of endoscopists to perform a complete optical diagnosis of colorectal polyps between 5 and 15 mm, and the impact of the only endoscopic diagnosis on the follow-up program for those patients. This is a prospective study in which we compare the diagnosis regarding size and histology made by the endoscopist versus de pathologic diagnosis.

Study Overview

Status

Completed

Conditions

Detailed Description

Background: Optical diagnosis of colonic polyps is an attractive possibility and a common practice. However, recommendations and the main decision concerning patients' management still rely on histological diagnosis, with controversial results in previous studies, usually designed to analyze the accuracy of this diagnosis in the setting of a 'resect and discard' or 'diagnose and leave' strategy. However, little has been studied on this diagnosis on polyps of about 10 mm, the threshold for the consideration as a high risk adenoma, that need a 3 year colonoscopy, or, in case of a smaller adenoma, with a recommended revision in 5 years. Some studies have addressed the accuracy when estimating the polyp size, and others the histology by means of virtual or optical chromoendoscopy, but no one has studied both parameters, that are the two pillars in which a revision program for the patient is decided.

Hypothesis: Our main purpose is to determine the accuracy of the complete optical diagnosis as made by the endoscopist in the endoscopy room, in order to give recommendations immediately after the colonoscopy, with no need of further histological analyses.

Aims:

  • To establish endoscopist accuracy, in different hospital settings, to predict size and histology of polyps between 5 and 15 mm and whether follow-up recommedations based on this diagnosis are accurate enough, when compared to the pathologic diagnosis.
  • To evaluate accuracy of the optical size estimation by the endoscopist, with respect to the measurement after resection and by the pathologist (after formaline fixation).
  • To analyze the rate of sessile serrated adenoma not diagnosed by the endoscopista on site.
  • To determine the proportion of incomplete resection and complications with different resection techniques.
  • To follow-up patients with high risk adenoma with the aim to establish the best follow-up schedule for those patients, and clarify this topic, still subjected to uncertainty.

Study Type

Observational

Enrollment (Actual)

545

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

      • Granada, Spain, 18014
        • "Virgen de las Nieves" University Hospital

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years to 80 years (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Sampling Method

Non-Probability Sample

Study Population

Patients that come to the endoscopy unit for colorectal cancer screening or with a specific clinical indication during the study period, in any of the participating hospitals.

Description

Inclusion Criteria:

  • Age between 18-80 years
  • Colorectal polyps with an estimated size (endoscopist estimation) between 5 and 15 mm.
  • Consent to be included in the protocol.

Exclusion Criteria:

  • Polyps sized <5 mm or >15 mm
  • Polyps that cannot be resected.
  • Polys that cannot be sent for pathologic study.
  • Peacemeal resection.
  • Polyposis syndromes with a previous histologic diagnosis.
  • Patients do not consent to participate in the study.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Concordance of optical diagnosis with pathologic diagnosis
Time Frame: Immediate after the polyps detection
Optical diagnosis accuracy (endoscopist) when compared to the Pathologic report
Immediate after the polyps detection
Precision in polyps sizing the pathologist
Time Frame: Immediate after resection and within 10 days after polyp resection to allow pathologic diagnosis
Comparison of sizes after resection and after formaline and pathologic diagnosis
Immediate after resection and within 10 days after polyp resection to allow pathologic diagnosis

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Rate of polyps' recurrence at the end of the follow-up.
Time Frame: 5 years after the index resection
Polyps recurrence after long-term follow up for advanced adenoma (Rate)
5 years after the index resection

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Collaborators

Investigators

  • Principal Investigator: Clara Heredia-Carrasco, MD, 'Virgen de las Nieves' University Hospital. Granada

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

December 22, 2019

Primary Completion (Actual)

December 1, 2021

Study Completion (Actual)

January 31, 2022

Study Registration Dates

First Submitted

January 14, 2020

First Submitted That Met QC Criteria

January 14, 2020

First Posted (Actual)

January 18, 2020

Study Record Updates

Last Update Posted (Actual)

May 17, 2022

Last Update Submitted That Met QC Criteria

May 16, 2022

Last Verified

May 1, 2022

More Information

Terms related to this study

Other Study ID Numbers

  • POPS.HUVN.19

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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