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Koloskopi vs afføringstest for ældre voksne tyktarmspolypper (COOP)

29. september 2026 opdateret af: Audrey H. Calderwood, Dartmouth-Hitchcock Medical Center

Koloskopi versus afføringsbaseret test for ældre voksne med en historie med kolonpolypper

This is a multi-site comparative effectiveness randomized controlled trial (RCT) comparing annual fecal immunochemical testing (FIT) and colonoscopy for post-polypectomy surveillance among adults aged 65-82 with a history of colorectal polyps who are due for surveillance colonoscopy.

Studieoversigt

Status

Rekruttering

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

Colon polyps are common among adults ≥50 years and people with colon polyps are recommended to undergo regular follow-up colonoscopy (surveillance) in hopes of preventing subsequent colorectal cancer (CRC). Older adults, particularly those who are age ≥70 years, most of whom have a history of only small colon polyps, may benefit little from repeated colonoscopies because of the increased risks of colonoscopy due to age and co-morbidities and potentially limited life expectancy due to other competing medical problems - CRC may never be a problem for them. Older adults may also be hesitant to get repeated colonoscopy because of the risk of complications (e.g., bleeding, perforation, etc.) and inconvenience. More surveillance options are needed to help address the concerns and challenges with repeated colonoscopies in older adults with a history of low-risk polyps.

FIT is a noninvasive, stool-based test that is recommended and widely used in the US and globally for CRC screening in average-risk adults 45 to 75 years of age. In addition, FIT is already standard of care as a surveillance option for patients with a history of low-risk adenomas in Canada and has been shown to be equivalent to colonoscopy for screening of certain high-risk populations (e.g., those with a family history of CRC). However, FIT's role for surveillance among older adults who have a history of low-risk adenomas has not been studied in the US nor among older adults who may benefit from this noninvasive surveillance approach.

The COOP Trial will fill this evidence gap and shed light on patient-, clinician-, and system-factors relevant to FIT for surveillance that together could potentially transform surveillance guidelines in the US and beyond

The purpose of this study is to compare annual at-home stool-based testing, with a fecal immunochemical test (FIT), to colonoscopy in adults age 65-82 who have a history of colorectal polyps. The goal of the study is to compare how well FIT works compared to colonoscopy in looking for and finding colorectal cancer in older adults who have a history of colorectal polyps, as well as to understand people's experiences with using it compared to colonoscopy.

Undersøgelsestype

Interventionel

Tilmelding (Anslået)

6434

Fase

  • Ikke anvendelig

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiekontakt

Studiesteder

    • Alberta
      • Calgary, Alberta, Canada, T2N 5A1
        • Rekruttering
        • University of Calgary
        • Kontakt:
    • British Columbia
      • Vancouver, British Columbia, Canada, V6Z 1Y6
        • Rekruttering
        • University of British Columbia
        • Kontakt:
    • Manitoba
      • Winnipeg, Manitoba, Canada, R3EOW3
    • Ontario
      • London, Ontario, Canada, N6A 5W9
        • Rekruttering
        • London Health Sciences Centre Research Institute
        • Kontakt:
    • Alabama
      • Birmingham, Alabama, Forenede Stater, 35233
        • Aktiv, ikke rekrutterende
        • University of Alabama Birmingham
    • Arizona
      • Tucson, Arizona, Forenede Stater, 85719
        • Rekruttering
        • University of Arizona
        • Kontakt:
    • California
      • San Diego, California, Forenede Stater, 92161
        • Rekruttering
        • Jennifer Moreno Department of Veterans Affairs Medical Cneter
        • Kontakt:
          • Dr. Samir Gupta
      • Walnut Creek, California, Forenede Stater, 94596
        • Rekruttering
        • Kaiser Permanente Northern California
        • Kontakt:
    • Colorado
    • District of Columbia
      • Washington D.C., District of Columbia, Forenede Stater, 20010
        • Rekruttering
        • MedStar Health
        • Ledende efterforsker:
          • Jennifer Tran, MD
        • Kontakt:
    • Florida
      • Tampa, Florida, Forenede Stater, 33612-4745
        • Rekruttering
        • James A. Haley Veterans Hospital
        • Kontakt:
    • Illinois
      • Chicago, Illinois, Forenede Stater, 60611
        • Rekruttering
        • Northwestern Memorial Hospital
        • Ledende efterforsker:
          • Rajesh Keswani, MD
        • Kontakt:
    • Indiana
      • Indianapolis, Indiana, Forenede Stater, 46202
        • Rekruttering
        • Richard L. Roudebush VA Medical Center
        • Kontakt:
    • Michigan
      • Ann Arbor, Michigan, Forenede Stater, 48105
        • Rekruttering
        • University of Michigan Health
        • Kontakt:
        • Ledende efterforsker:
          • Stacy Menees, MD
      • Detroit, Michigan, Forenede Stater, 48202
        • Rekruttering
        • Henry Ford
        • Kontakt:
    • Missouri
      • St Louis, Missouri, Forenede Stater, 63110
        • Rekruttering
        • Washington University School of Medicine
        • Kontakt:
          • Dr. Cassandra Fritz, MD
          • Telefonnummer: (314) 374-8335
          • E-mail: cfritz@wustl.edu
    • New Hampshire
      • Lebanon, New Hampshire, Forenede Stater, 03756
        • Rekruttering
        • Dartmouth Health
        • Kontakt:
    • New York
      • New York, New York, Forenede Stater, 10010
        • Rekruttering
        • New York Harbor Health Care System - Dept of Veterans Affairs
        • Kontakt:
    • North Carolina
      • Charlotte, North Carolina, Forenede Stater, 28204
        • Rekruttering
        • Wake Forest University Health Sciences
        • Kontakt:
    • Oregon
      • Portand, Oregon, Forenede Stater, 97232
        • Afsluttet
        • Kaiser Permanente Northwest
      • Portland, Oregon, Forenede Stater, 97239
        • Rekruttering
        • Oregon Health & Science University (Knight Cancer Institute)
        • Kontakt:
    • Utah
      • Salt Lake City, Utah, Forenede Stater, 84112
        • Rekruttering
        • University of Utah
        • Kontakt:
        • Kontakt:
          • Lynette Holman
      • Sandy City, Utah, Forenede Stater, 84094
        • Rekruttering
        • Intermountain Health
        • Kontakt:
    • Virginia
      • Charlottesville, Virginia, Forenede Stater, 22903
        • Rekruttering
        • University of Virginia Health
        • Kontakt:

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

65 år til 82 år (Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Beskrivelse

Inclusion Criteria:

  • English or Spanish speaking
  • Personal history of colorectal polyps
  • Most recent colonoscopy with ≤2 non-advanced polyps
  • Currently due or coming due within 12 months for colonoscopy
  • Able to provide written informed consent

Exclusion Criteria:

  • Personal history of colorectal cancer
  • Personal history of genetic syndrome with high risk for colorectal cancer (e.g. Lynch Syndrome, Familial Adenomatous Polyposis Syndrome (FAP), or Serrated Polyposis Syndrome)
  • Personal history of inflammatory bowel disease (e.g. ulcerative colitis, Crohn's disease)
  • Most recent colonoscopy with advanced polyp(s) or ≥3 non-advanced polyps
  • Patients unlikely to benefit from polyp surveillance (e.g., history of heart disease or coronary artery disease with treatment in the last 6 months, heart failure affecting function, lung disease requiring use of home oxygen, stroke within the last 4 months, dementia affecting activities of daily living (ADL) or instrumental activities of daily living (IADL), severe liver disease requiring the use of certain medications to control fluid, confusion, or bleeding, severe kidney disease requiring dialysis, or a new cancer diagnosis within the last year)
  • Patients unable to provide written informed consent

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Forebyggelse
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Ingen (Åben etiket)

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Aktiv komparator: FIT

FIT (annual)

Annual FIT

Aktiv komparator: Colonoscopy

Surveillance colonoscopy (one time)

One time surveillance colonoscopy

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Incidence of advanced neoplasia in each study group, annual FIT and colonoscopy, assessed by comparing the detection of advanced neoplasia between the two study groups.
Tidsramme: Up to 11 years

The investigators will determine the incidence of advanced neoplasia, defined as adenocarcinoma of the colon or rectum or adenomas or serrated polyps ≥1 cm in size or with villous features or any dysplasia, or traditional serrated polyps, in both study groups through annual surveys asking about any changes in polyp history or new cancer diagnosis for up to 6 years and medical record review for up to 11 years. The incidence of advanced neoplasia will be compared between the two study group cumulatively after all the data has been collected.

Up to 11 years

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Change from baseline Satisfaction and Trust of colorectal screening testing assessed by Tiro et al (2005) Response Efficacy sub-scale from the general colorectal cancer screening survey.
Tidsramme: Baseline, 1 year after surveillance colonoscopy, annually after each completed FIT for up to 6 years

The Response Efficacy sub-scale from the general colorectal cancer screening survey is a 2 item scale with five response options (1=strongly disagree, 2=mildly disagree, 3=don't know, 4=mildly agree, 5=strongly agree), such that each individual attains a score ranging from 2 to 10.

Baseline, 1 year after surveillance colonoscopy, annually after each completed FIT for up to 6 years
Change from baseline worry about colorectal Cancer assessed by the Cancer Worry Scale (CWS)
Tidsramme: Baseline and annually for up to 6 years

The Cancer Worry Scale is a six-item scale designed to measure worry about the risk of developing cancer and the impact of worry on daily functioning. The scale consists of six questions with four response options (1 = not at all or rarely; 2 = sometimes; 3 = often; 4 = almost all the time), such that each individual attains a score ranging from 6 (minimum worry) to 24 (maximum worry).

Baseline and annually for up to 6 years
Change from baseline Perceived colorectal cancer susceptibility using Absolute perceived susceptibility to colorectal polyps subscale from McQueen (2010)
Tidsramme: Baseline, annually for up to 6 years

The absolute perceived susceptibility to colorectal polyps subscale from McQueen (2010) is a three-question scale using four-point Likert format ranging from 1= strongly disagree to 4=strongly agree, such that each individual attains a score ranging from 3 (minimum susceptibility) to 12 (maximum susceptibility).

Baseline, annually for up to 6 years
Change from baseline Emotional benefit of surveillance assessed by a modified version of the Psychological Consequences Questionnaire (PCQ)
Tidsramme: Baseline and annually for up to 6 years

The PCQ is a 22 question scale that has four response options (1=Not at all, 2=a little bit, 3=quite a bit, 4=a great deal) such that each individual attains a score ranging from 22 to 88.

Baseline and annually for up to 6 years
Change from baseline perceived global health assessed by the Patient-Reported Outcomes Measurement Information System-Global 10
Tidsramme: Baseline and annually for up to 6 years

The Patient-Reported Outcomes Measurement Information System-10 is a 10-item scale that has five response options (5=excellent, 4=very good, 3=good, 2=fair, 1=poor) which assess overall QOL. Raw scores are transformed into T scores; higher T scores indicate greater endorsement of the construct being assessed. Scoring supports two summary scores: A Global Physical Health (GPH) score and a Global Mental Health (GMH) score.

Baseline and annually for up to 6 years
Major and minor harms within 30 days of colonoscopy, as measured through chart review and telephone interview.
Tidsramme: 30-45 days post colonoscopy for up to 6 years

Major and minor harms within 30 days of colonoscopy will be collected through chart review and a telephone interview with participants 30-45 post study surveillance colonoscopy or study colonoscopy for positive FIT. The incidence of harms will be compared between the study groups (annual FIT and colonoscopy).

30-45 days post colonoscopy for up to 6 years

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Samarbejdspartnere

Efterforskere

  • Ledende efterforsker: Audrey H Calderwood, MD, MS, Dartmouth-Hitchcock Medical Center
  • Ledende efterforsker: Theodore R Levin, MD, Kaiser Permante Northern California

Publikationer og nyttige links

Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.

Generelle publikationer

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Faktiske)

14. juni 2023

Primær færdiggørelse (Anslået)

31. maj 2030

Studieafslutning (Anslået)

31. december 2035

Datoer for studieregistrering

Først indsendt

4. november 2022

Først indsendt, der opfyldte QC-kriterier

4. november 2022

Først opslået (Faktiske)

10. november 2022

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

2. oktober 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

29. september 2026

Sidst verificeret

1. maj 2026

Mere information

Begreber relateret til denne undersøgelse

Andre undersøgelses-id-numre

  • STUDY02001984
  • PLACER-2020C3-20955 (Andet bevillings-/finansieringsnummer: Patient-Centered Outcomes Research Institute (PCORI))

Plan for individuelle deltagerdata (IPD)

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