Colonoscopy vs Stool Testing for Older Adults With Colon Polyps

NCT ID: NCT05612347

Last Updated: 2025-09-23

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

RECRUITING

Clinical Phase

NA

Total Enrollment

8946 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-06-14

Study Completion Date

2035-12-31

Brief Summary

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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.

Detailed Description

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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.

Conditions

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Colorectal Polyp Colorectal Neoplasms Colorectal Adenoma Colorectal Cancer Digestive System Disease

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

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FIT

FIT (annual)

Group Type ACTIVE_COMPARATOR

FIT

Intervention Type DIAGNOSTIC_TEST

Annual FIT

Colonoscopy

Surveillance colonoscopy (one time)

Group Type ACTIVE_COMPARATOR

Colonoscopy

Intervention Type DIAGNOSTIC_TEST

One time surveillance colonoscopy

Interventions

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FIT

Annual FIT

Intervention Type DIAGNOSTIC_TEST

Colonoscopy

One time surveillance colonoscopy

Intervention Type DIAGNOSTIC_TEST

Eligibility Criteria

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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
Minimum Eligible Age

65 Years

Maximum Eligible Age

82 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Dartmouth-Hitchcock Medical Center

OTHER

Sponsor Role lead

Patient-Centered Outcomes Research Institute

OTHER

Sponsor Role collaborator

Responsible Party

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Audrey H. Calderwood

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Audrey H Calderwood, MD, MS

Role: PRINCIPAL_INVESTIGATOR

Dartmouth-Hitchcock Medical Center

Theodore R Levin, MD

Role: PRINCIPAL_INVESTIGATOR

Kaiser Permante Northern California

Locations

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University of Alabama Birmingham

Birmingham, Alabama, United States

Site Status ACTIVE_NOT_RECRUITING

University of Arizona

Tucson, Arizona, United States

Site Status RECRUITING

Kaiser Permanente Northern California

Walnut Creek, California, United States

Site Status RECRUITING

University of Colorado

Aurora, Colorado, United States

Site Status RECRUITING

MedStar Health

Washington D.C., District of Columbia, United States

Site Status RECRUITING

James A. Haley Veterans Hospital

Tampa, Florida, United States

Site Status RECRUITING

Northwestern Memorial Hospital

Chicago, Illinois, United States

Site Status RECRUITING

University of Chicago

Chicago, Illinois, United States

Site Status RECRUITING

Rockford Gastroenterology Associates

Rockford, Illinois, United States

Site Status RECRUITING

Richard L. Roudebush VA Medical Center

Indianapolis, Indiana, United States

Site Status RECRUITING

University of Michigan Health

Ann Arbor, Michigan, United States

Site Status RECRUITING

Dartmouth Health

Lebanon, New Hampshire, United States

Site Status RECRUITING

New York Harbor Health Care System - Dept of Veterans Affairs

New York, New York, United States

Site Status RECRUITING

Kaiser Permanente Northwest

Portand, Oregon, United States

Site Status ACTIVE_NOT_RECRUITING

Oregon Health & Science University (Knight Cancer Institute)

Portland, Oregon, United States

Site Status RECRUITING

Intermountain Health

Sandy City, Utah, United States

Site Status RECRUITING

University of Virginia Health

Charlottesville, Virginia, United States

Site Status RECRUITING

University of British Columbia

Vancouver, British Columbia, Canada

Site Status RECRUITING

University of Manitoba

Winnipeg, Manitoba, Canada

Site Status RECRUITING

Countries

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United States Canada

Central Contacts

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Kelsey M Veilleux, MD

Role: CONTACT

(603) 650-6226

Facility Contacts

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Joshua Melson, MD

Role: primary

5206266119

Jeffrey Lee, MD, MPH

Role: primary

Swati Patel, MD, MS

Role: primary

Theresa Moriarty

Role: primary

2028773657

Brijesh Patel, MD

Role: primary

(813) 619-5131

Zack Jacobs

Role: primary

3124729597

Dr. Neil Sengupta, MD

Role: primary

7737021290

Sunil Patel, MD

Role: primary

815-484-7980

Thomas Imperiale, MD

Role: primary

317-988-4859

Nabrah Lone

Role: primary

7346473635

Audrey Calderwood, MD, MS

Role: primary

(603) 650-0220

Aasma Shaukat, MD

Role: primary

Seth Crockett, MD, MPH

Role: primary

(503)494-2278

Dr. Christine Hachem, MD, FACG

Role: primary

8015072112

Cynthia Yoshida, MD

Role: primary

434-243-2124

Dr. Jennifer Telford, MD

Role: primary

6046886332

Harminder Singh, MD

Role: primary

2047893369

References

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Gupta S, Lieberman D, Anderson JC, Burke CA, Dominitz JA, Kaltenbach T, Robertson DJ, Shaukat A, Syngal S, Rex DK. Recommendations for Follow-Up After Colonoscopy and Polypectomy: A Consensus Update by the US Multi-Society Task Force on Colorectal Cancer. Gastroenterology. 2020 Mar;158(4):1131-1153.e5. doi: 10.1053/j.gastro.2019.10.026. Epub 2020 Feb 7. No abstract available.

Reference Type BACKGROUND
PMID: 32044092 (View on PubMed)

Dubé C, McCurdy BR, Bronstein T, et al. ColonCancerCheck Recommendations for Post-Polypectomy Surveillance, 2019. Available at: https://www.cancercareontario.ca/en/content/coloncancercheck-recommendations-post-polypectomy-surveillance

Reference Type BACKGROUND

Quintero E, Carrillo M, Gimeno-Garcia AZ, Hernandez-Guerra M, Nicolas-Perez D, Alonso-Abreu I, Diez-Fuentes ML, Abraira V. Equivalency of fecal immunochemical tests and colonoscopy in familial colorectal cancer screening. Gastroenterology. 2014 Nov;147(5):1021-30.e1; quiz e16-7. doi: 10.1053/j.gastro.2014.08.004. Epub 2014 Aug 13.

Reference Type BACKGROUND
PMID: 25127679 (View on PubMed)

Kothari ST, Huang RJ, Shaukat A, Agrawal D, Buxbaum JL, Abbas Fehmi SM, Fishman DS, Gurudu SR, Khashab MA, Jamil LH, Jue TL, Law JK, Lee JK, Naveed M, Qumseya BJ, Sawhney MS, Thosani N, Yang J, DeWitt JM, Wani S; ASGE Standards of Practice Committee Chair. ASGE review of adverse events in colonoscopy. Gastrointest Endosc. 2019 Dec;90(6):863-876.e33. doi: 10.1016/j.gie.2019.07.033. Epub 2019 Sep 25.

Reference Type BACKGROUND
PMID: 31563271 (View on PubMed)

Warren JL, Klabunde CN, Mariotto AB, Meekins A, Topor M, Brown ML, Ransohoff DF. Adverse events after outpatient colonoscopy in the Medicare population. Ann Intern Med. 2009 Jun 16;150(12):849-57, W152. doi: 10.7326/0003-4819-150-12-200906160-00008.

Reference Type BACKGROUND
PMID: 19528563 (View on PubMed)

Other Identifiers

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PLACER-2020C3-20955

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

STUDY02001984

Identifier Type: -

Identifier Source: org_study_id

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