National Colorectal Polyp Care

NCT ID: NCT03712059

Last Updated: 2022-01-04

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

Total Enrollment

12000 participants

Study Classification

OBSERVATIONAL

Study Start Date

2018-11-01

Study Completion Date

2020-09-30

Brief Summary

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This study has three main purposes:screening: the first purpose is to evaluate the diagnostic value of combintion of the life risk factors and immunochemical fecal occult blood test (FIT) on detection of colorectal neoplasia in Chinese population; resection: the second objective is to investigate the complete resection rate of colorectal adenoma and risk factors of incomplete resection in China; identification and classification: the third objective is to initially establish an artificial intelegence-assissted recognition and classification system of polyp based on deep learning.

Detailed Description

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This study is a multi-center cross-sectional survey and diagnostic test led by the National Clinical Research Center for Digestive Disease (Shanghai) (Department of Gastroenterology, Changhai Hospital, Naval Medical University), which is conducted at about 175 digestive endoscopy centers nationwide in China, with the expectation of including 12,000 patients (10,000 screenig and 2,000 adenoma resection). The basic characteristics of patients, bowel preparation method and quality, and related information of colonoscopy are recorded in detail. According to the research purpose, the whole project can be divided into three sections.

1. Screening section: All patients receive FIT test and colonoscopy, whose age, sex, family history, smoking history, body mass index (BMI), diabetes and other risk factors are collected by researchers through pad, equipped with a specially designed database and app. Using colonoscopy results as the gold standard, the risk prediction model for the Chinese population is explored, and the optimal strategy of colonoscopy practice for the Chinese established initially.
2. Resection section: During the polypectomy, for all pathologically confirmed or NBI-predicted adenomas with size\<10mm, 1-2 biopsies were randomly performed on the edge after resection to determine the completion rate of the polypectomy.
3. Identification and classification section: For Patients regardless of cancer diagnosis or polypectomy, if there is polyp, observation of narrow band imaging (NBI) with or without magnification is required, with 4 white light and NBI images collected and reserved, respectively. If there is magnifying endoscopy, another 4 endoscopic images of magnification are also required. Endoscopists are invited to predict the pathology of polyps according to the NBI International Colorectal Endoscopic (NICE) classification principle and endoscopic images, and upload the pathological results and endoscopic images within 2-4 week after colonoscopy.

Conditions

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Colorectal Polyp

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Screening group

All patients receive FIT test and colonoscopy, whose age, sex, family history, smoking history, body mass index (BMI), diabetes and other risk factors are collected by researchers through pad, equipped with a specially designed database and app. Using colonoscopy results as the gold standard, the diagnostic value of risk prediction model for the Chinese population is explored, and the optimal strategy of colonoscopy practice for the Chinese established initially.

FIT test and colonoscopy

Intervention Type DIAGNOSTIC_TEST

All included patients received FIT test and then colonoscopy, with the risk factors of CRC recorded. The diagnostic performance of predicting model (based on FIT and risk factors) and colonoscopy were compared.

Adenoma resection group

During the polypectomy of 2000 patients, for all pathologically confirmed or NBI-predicted adenomas with size\<10mm, 1-2 biopsies were randomly performed on the edge after resection to determine the completion rate of the polypectomy.

Polypectomy and biopsy

Intervention Type DIAGNOSTIC_TEST

All included patients received polypectomy, and then biopsy is performed on the edge of resection for patients with \< 10 mm adenoma (confirmed by pathology or predicted by NBI images), with the complete resection rate of polyps being calculated.

Identification and classification group

For 12000 patients regardless of cancer diagnosis or polypectomy, if there is polyp, NBI (magnification) observation is required, with 4 white light and NBI images collected and reserved, respectively. If there is magnifying endoscopy, another 4 endoscopic images of magnification are also required. Endoscopists are invited to predict the pathology of polyps according to the NICE classification principle and endoscopic images, and upload the pathological results and endoscopic images within 2-4 week after colonoscopy.

FIT test and colonoscopy

Intervention Type DIAGNOSTIC_TEST

All included patients received FIT test and then colonoscopy, with the risk factors of CRC recorded. The diagnostic performance of predicting model (based on FIT and risk factors) and colonoscopy were compared.

Polypectomy and biopsy

Intervention Type DIAGNOSTIC_TEST

All included patients received polypectomy, and then biopsy is performed on the edge of resection for patients with \< 10 mm adenoma (confirmed by pathology or predicted by NBI images), with the complete resection rate of polyps being calculated.

Classification

Intervention Type DIAGNOSTIC_TEST

Pathology of polyps is classified by endoscopists through NICE principle and the performance of classification between endoscopists and computer is compared.

Interventions

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FIT test and colonoscopy

All included patients received FIT test and then colonoscopy, with the risk factors of CRC recorded. The diagnostic performance of predicting model (based on FIT and risk factors) and colonoscopy were compared.

Intervention Type DIAGNOSTIC_TEST

Polypectomy and biopsy

All included patients received polypectomy, and then biopsy is performed on the edge of resection for patients with \< 10 mm adenoma (confirmed by pathology or predicted by NBI images), with the complete resection rate of polyps being calculated.

Intervention Type DIAGNOSTIC_TEST

Classification

Pathology of polyps is classified by endoscopists through NICE principle and the performance of classification between endoscopists and computer is compared.

Intervention Type DIAGNOSTIC_TEST

Eligibility Criteria

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Inclusion Criteria

1. Age between 18 to 75 years old and patients with or without alarming gastrointestinal symptoms were analyzed separately.
2. 3-4 L polyethylene glycol and foaming agent are used for bowel preparation.
3. Withdrawal time ≥6mins (excluding the time of biopsy)

Exclusion Criteria

1. A history of acute myocardial infarction (within 6 months), severe heart, liver, kidney dysfunction, or mental illness.
2. Patients taking anticoagulants such as aspirin and warfarin, or who have coagulopathy.
3. Patients with inflammatory bowel disease and colon polyposis.
4. History of colonic procedure (including surgery, polypectomy, EMR, and ESD) in the screening section
5. Diameter of polyp greater than 1cm, lateral developmental lesions (LST), colon cancer, lesions requiring ESD and surgery
6. Patients participating in other clinical trials now or within 60 days.
7. Intestinal obstruction.
Minimum Eligible Age

18 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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175 medical centers in China

AMBIG

Sponsor Role collaborator

Changhai Hospital

OTHER

Sponsor Role lead

Responsible Party

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Zhaoshen Li

Director of Gastroenterology Dept and Digestive Endoscopy Center

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Changhai Hospital, Second Military Medical University

Shanghai, , China

Site Status

Countries

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China

References

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Wong MC, Lam TY, Tsoi KK, Hirai HW, Chan VC, Ching JY, Chan FK, Sung JJ. A validated tool to predict colorectal neoplasia and inform screening choice for asymptomatic subjects. Gut. 2014 Jul;63(7):1130-6. doi: 10.1136/gutjnl-2013-305639. Epub 2013 Sep 17.

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Other Identifiers

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NCPC

Identifier Type: -

Identifier Source: org_study_id

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