Participation in Competing Strategies for Colorectal Cancer Screening - a Randomized Health Services Study Within the National Screening Program in Poland

NCT ID: NCT03790475

Last Updated: 2018-12-31

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

UNKNOWN

Clinical Phase

NA

Total Enrollment

12298 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-08-25

Study Completion Date

2019-12-31

Brief Summary

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The PICCOLINO is a randomized health services study performed within the framework of the Polish Colonoscopy Screening Program (PCSP) in Poland.

Within the study 12,298 eligible persons between 55 and 64 years of age will be drawn from the Population Registry and randomly assigned in a 1:1:1 ratio to receive an invitation to participate in one of the three screening strategies: (I) postal invitation to colonoscopy and a re-invitation to colonoscopy for initial non-responders, (II) postal invitation for screening using fecal immunochemical test (FIT) for non-responders and subjects refusing a colonoscopy, or (III) postal invitation offering a choice between FIT and colonoscopy.

Colonoscopies will be performed in seven local centers participating in the study. FITs will be analyzed in the central laboratory. Subjects with positive FIT result will be recommended to undergo colonoscopy.

The primary outcome is participation with CRC screening within 18 weeks after enrollment, defined as completion of colonoscopy, or completion of FIT along with colonoscopy for positive FIT result. Secondary outcome will be diagnostic yield for advanced neoplasia (CRC or advanced adenoma). The study has been approved by a local bioethics committee.

Detailed Description

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Conditions

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Colorectal Cancer

Keywords

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Colorectal Cancer Screening

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

HEALTH_SERVICES_RESEARCH

Blinding Strategy

NONE

Study Groups

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Current screening practice.

Subjects randomized into this group will receive named invitations for colonoscopy with pre-specified date, contact details of dedicated screening center. Invitations will be sent 6 weeks prior to suggested date of screening test. All subjects not responding to the invitation will receive a reminder letter 3 weeks prior to proposed appointment date. Additionally, a re-invitation for colonoscopy (screening test in 6 weeks) will be sent to participants not responding to the first invitation and the reminding letter.

Group Type NO_INTERVENTION

No interventions assigned to this group

Sequential screening strategy.

Subjects randomized into this group will be initially invited to participate in a screening colonoscopy as per group 1. All subjects who will refuse colonoscopy or do not respond to invitation within 6 weeks since the first letter, will receive another invitation letter with FIT test enclosed.

The screening office will contact persons with a positive test result in order to determine the date of the colonoscopy appointment.

A negative test result will be sent together with a recommendation to have another screening test performed 2 years later and information about the possible delivery of the test in two years.

Group Type EXPERIMENTAL

Offering an alternative colorectal cancer screening method

Intervention Type OTHER

Persons randomized to the sequential screening strategy group will receive a postal invitation to the colonoscopy followed by a postal invitation for screening using FIT for non-responders and subjects refusing colonoscopy.

Multiple options screening strategy.

Subjects in this group will receive a letter with an offer to choose between colonoscopy or FIT screening.

The first letter will include an invitation with a scheduled date of colonoscopy (in 6 weeks) and a FIT kit.

Three weeks before a scheduled date of colonoscopy subjects randomized into this group will receive a reminder letter with an information about proposed screening methods. After the scheduled date of the colonoscopy examination, subjects who will not respond to the invitation for colonoscopy and will not send the FIT test back to the laboratory will receive another invitation for colonoscopy (in 6 weeks) and a FIT kit.

Group Type EXPERIMENTAL

Offering a choice for colorectal cancer screening

Intervention Type OTHER

Persons randomized to the multiple options screening strategy group will receive a postal invitation offering a choice between FIT and colonoscopy.

Interventions

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Offering a choice for colorectal cancer screening

Persons randomized to the multiple options screening strategy group will receive a postal invitation offering a choice between FIT and colonoscopy.

Intervention Type OTHER

Offering an alternative colorectal cancer screening method

Persons randomized to the sequential screening strategy group will receive a postal invitation to the colonoscopy followed by a postal invitation for screening using FIT for non-responders and subjects refusing colonoscopy.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

Men and women aged 55 to 64 years residing in Poland and assigned to be invited to screening within the Polish Colonoscopy Screening Program .

Exclusion Criteria

* information of a selected subject death informed by family, neighbors or post office that has not been included in the Personal Identity Number (PESEL) system.
* addressees of letters that have been returned by the post office.
* subjects requiring long-term care due to somatic, psychosocial reasons or with mental disability.
* history of colorectal resection.
Minimum Eligible Age

55 Years

Maximum Eligible Age

64 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Ministry of Health, Poland

OTHER_GOV

Sponsor Role collaborator

Centre of Postgraduate Medical Education

OTHER

Sponsor Role collaborator

Maria Sklodowska-Curie National Research Institute of Oncology

OTHER

Sponsor Role lead

Responsible Party

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Michal F. Kaminski, MD, PhD

MD, PhD

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Maria Sklodowska-Curie Institute - Oncology Center

Warsaw, , Poland

Site Status RECRUITING

Countries

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Poland

Central Contacts

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Michal Filip Kaminski, MD, PhD

Role: CONTACT

Phone: +48 605438330

Email: [email protected]

Nastazja Dagny Pilonis, MD

Role: CONTACT

Phone: +48 510291110

Email: [email protected]

Facility Contacts

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Michal Filip Kaminski, MD, PhD

Role: primary

Nastazja Dagny Pilonis, MD

Role: backup

References

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Pilonis ND, Bugajski M, Wieszczy P, Rupinski M, Pisera M, Pawlak E, Regula J, Kaminski MF. Participation in Competing Strategies for Colorectal Cancer Screening: A Randomized Health Services Study (PICCOLINO Study). Gastroenterology. 2021 Mar;160(4):1097-1105. doi: 10.1053/j.gastro.2020.11.049. Epub 2020 Dec 9.

Reference Type DERIVED
PMID: 33307024 (View on PubMed)

Other Identifiers

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43/PB/2018

Identifier Type: -

Identifier Source: org_study_id