Pilot Evaluation of Fecal Immunologic Test (FIT) in Ontario

NCT ID: NCT01754896

Last Updated: 2014-12-23

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

28 participants

Study Classification

INTERVENTIONAL

Study Start Date

2012-04-30

Study Completion Date

2013-04-30

Brief Summary

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Prior to implementation of new colorectal cancer (CRC) screening technology (fecal immunochemical test - FIT) in Ontario, there is a need for a laboratory and field assessment to validate and optimize its use in the Ontario climate and conditions (e.g., large geographic area) and to determine whether adjustments to the current structure of the ColonCancerCheck (CCC) Program would be required.

This study consists of 2 phases. Phase 1 consists of laboratory testing of FIT kits to evaluate analytical performance relevant to the requirements of the CCC Program. Phase 2 is a field assessment to evaluate the effect of different distribution and return methods and pre-labeling of kits on uptake and completion of the tests. The entire study will take 12-18 months to complete, with patients being recruited through family physicians in patient enrollment model (PEM) family practices across the province of Ontario.

This Clinical Trials registration relates to Phase 2 of the study.

Detailed Description

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In 2008 Ontario launched the ColonCancerCheck (CCC) Program, an organized colorectal cancer (CRC) screening program in which average risk patients are offered an at-home screening test and increased risk patients are offered colonoscopy directly through their family physician.

Currently, Ontario's CCC Program utilizes guaiac fecal occult blood testing (gFOBT) in persons at average risk of CRC. However, the program is currently considering a change to fecal immunochemical testing (FIT).

FIT, which comes in quantitative and qualitative formats, is superior to the gFOBT from a scientific perspective because it specifically detects human hemoglobin. gFOBT uses an indirect detection which depends on a peroxidase reaction not specific for human hemoglobin. FIT methodology is also both more convenient and superior from a participant perspective and multiple studies have demonstrated higher participation rates and improved detection of CRC precursors as well as invasive CRCs with FIT compared to gFOBT.

Organized CRC screening programs considering quantitative FIT face certain additional challenges, including uncertain stability over time and tolerance to variation in temperature following sample collection and prior to arrival in a testing laboratory. Prior to implementation of FIT in Ontario, there is a need for a laboratory and field assessment to validate and optimize its use in the Ontario climate and conditions (e.g., large geographic area) and to determine whether adjustments to the current structure of the CCC Program would be required.

This study consists of 2 phases. Phase 1, laboratory testing, assesses 2 quantitative and 3 qualitative FIT kits to evaluate analytical performance relevant to the requirements of the CCC Program. Phase 2 is a field assessment to evaluate the effect of different distribution and return methods and pre-labeling of kits on uptake and completion of the tests. The entire study will take 12-18 months to complete, with patients being recruited through family physicians in patient enrollment model (PEM) family practices across the province of Ontario. Data collection will take place for 6 months, starting on the day that screening kits and/or invitation letters are mailed to patients.

This Clinical Trials registration relates to Phase 2 of the study.

Conditions

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Colorectal Cancer

Keywords

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colorectal cancer fecal immunochemical test fecal occult blood test screening

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

FACTORIAL

Primary Study Purpose

HEALTH_SERVICES_RESEARCH

Blinding Strategy

NONE

Study Groups

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Mail-out/Mail-back

Mailing of FIT kit directly to patient. Mailing completed kits in for processing.

Group Type EXPERIMENTAL

mailing of FIT kit directly to patient

Intervention Type OTHER

Patient receives a mailed invitation to participate in CRC screening, with a FIT screening kit included.

mailing completed kits in for processing

Intervention Type OTHER

Patients mails completed kit in for processing using postage-paid reply envelope provided.

Mail-out/Drop-off

Mailing of FIT kit directly to patient. Dropping completed kits at lab for processing.

Group Type EXPERIMENTAL

mailing of FIT kit directly to patient

Intervention Type OTHER

Patient receives a mailed invitation to participate in CRC screening, with a FIT screening kit included.

dropping completed kits at lab for processing

Intervention Type OTHER

Patient takes completed FIT in to lab patient service centre for processing.

Pick-up/Mail-back

Mailed invitation to pick up lab requisition and then kit. Mailing completed kits in for processing.

Group Type EXPERIMENTAL

mailed invitation to pick up lab requisition and then kit

Intervention Type OTHER

Patients receives a mailed invitation to visit their physician to discuss CRC screening. At that visit, they would receive a FIT laboratory requisition, which they will take to a local lab patient service centre to pick up a FIT kit.

mailing completed kits in for processing

Intervention Type OTHER

Patients mails completed kit in for processing using postage-paid reply envelope provided.

Pick-up/Drop-off

Mailed invitation to pick up lab requisition and then kit. Dropping completed kits at lab for processing.

Group Type EXPERIMENTAL

mailed invitation to pick up lab requisition and then kit

Intervention Type OTHER

Patients receives a mailed invitation to visit their physician to discuss CRC screening. At that visit, they would receive a FIT laboratory requisition, which they will take to a local lab patient service centre to pick up a FIT kit.

dropping completed kits at lab for processing

Intervention Type OTHER

Patient takes completed FIT in to lab patient service centre for processing.

Interventions

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mailing of FIT kit directly to patient

Patient receives a mailed invitation to participate in CRC screening, with a FIT screening kit included.

Intervention Type OTHER

mailed invitation to pick up lab requisition and then kit

Patients receives a mailed invitation to visit their physician to discuss CRC screening. At that visit, they would receive a FIT laboratory requisition, which they will take to a local lab patient service centre to pick up a FIT kit.

Intervention Type OTHER

mailing completed kits in for processing

Patients mails completed kit in for processing using postage-paid reply envelope provided.

Intervention Type OTHER

dropping completed kits at lab for processing

Patient takes completed FIT in to lab patient service centre for processing.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Physician in Ontario with a patient enrollment model
* patient: 50-74, Ontario resident, enrolled with physician

Exclusion Criteria

* patient: no personal or first degree relative family history of CRC, no FOBT within prior 5 years, colonoscopy within past 10 years, FOBT within past 2 years
Minimum Eligible Age

50 Years

Maximum Eligible Age

74 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Cancer Care Ontario

OTHER

Sponsor Role collaborator

Sunnybrook Health Sciences Centre

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Jill Tinmouth, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Sunnybrook Research Institute

Linda Rabeneck, MD, MPH

Role: PRINCIPAL_INVESTIGATOR

Cancer Care Ontario

Lawrence Paszat, MD, SM

Role: PRINCIPAL_INVESTIGATOR

Institute for Clinical Evaluative Studies (ICES)

Nancy Baxter, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

St. Michaels Hospital

Edward Randall, PhD, DCC

Role: PRINCIPAL_INVESTIGATOR

Eastern Health

Locations

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Dr. Jill Tinmouth

Toronto, Ontario, Canada

Site Status

Countries

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Canada

Other Identifiers

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209-2011

Identifier Type: -

Identifier Source: org_study_id