NCT05080673ClinicalTrials.gov

Five or Ten Year Colonoscopy for 1-2 Non-Advanced Adenomatous Polyps

En recrutementAccepte des participants actuellement, selon la fiche du registre.

Contacter cette étude

En bref

This trial examines colorectal cancer incidence in participants with 1 to 2 non-advanced adenomas randomized to surveillance colonoscopy at 10 years compared to participants randomized to surveillance colonoscopy at 5 and 10 years.

Interventionnelle9 500 participants recherchés493 sites2 pays

Catégories

Oncologie83%Gastro-entérologie et hépatologie17%

Enregistré dans 1 registre

ClinicalTrials.govNCT05080673Ouvrir cette fiche sur ClinicalTrials.govSynchronisé il y a 3 semaines

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How this study is set up

The points below are drawn from the public registry record for this study. Each one cites the field or sentence it came from. A dash (—) means the record does not state something — not that it is missing or wrong. Many well-run studies, especially small ones, leave some of these blank.

Present: Registered before enrolment beganFirst posted 2021-10-18; recorded start 2022-02-09
Present: Has a defined primary outcomeA primary outcome measure is listed in the record
Present: The primary outcome states a time frameThe primary outcome measure records a time frame
Present: Participants are randomly assignedAllocation is recorded as randomised
Present: Has a comparison groupThe record lists a placebo or comparator arm, or more than one study arm
Not stated: Open label (no blinding)Masking is recorded as none (open label)
Not stated: An ethics committee is not stated in the registry recordThis registry's ingested record has no ethics-committee field
Not stated: Regulatory oversight (such as an IND or IDE) is not stated in the registry recordThis registry's ingested record has no regulatory-authorisation field
Not stated: A data monitoring committee is not stated in the registry recordThis registry's ingested record has no data-monitoring-committee fieldA data monitoring committee is not required for many smaller studies, and its absence here is not unusual.
Present: No cost to participants is mentioned in the recordChecked the summary, description and eligibility text; no cost-to-participant phrase found
Present: Sponsor has 49 other studies in this databaseCounted from the lead sponsor named in the record (NRG Oncology)
Present: Sponsor has posted results for at least one studyBased on the sponsor’s studies in this database

The record lists 2 conditions.
Lead sponsor type recorded as: other.

These are facts from the public registry record, not a judgement about the study. Discuss any trial with your own doctor before taking part.

What these facts mean, and what to ask · ruleset v1

Trial stature

Three independent measures of this study, described from its registry record — not a recommendation about it. A rigorous study by investigators nobody has heard of is better evidence than a weak study led by a famous one. How these are scored.

Methodological rigourMODERATE

A moderately rigorous design for a study of this type, judged from its ClinicalTrials.gov record.

How this score is built

Randomised allocation20/20
Participants are randomly allocated between arms
Blinding0/20
Open-label
Control arm0/15
No comparator arm stated in the record
Primary-outcome specificity10/10
Named primary outcome with a defined time frame
Endpoint type3/10
Surrogate or intermediate endpoint (conservative default)
Multi-centre8/8
Multi-centre: 485 sites
Data monitoring committee7/7
A data monitoring committee is in place
Prospective registration5/5
Registered before the study start date
Protocol / SAP posted0/5
No protocol or SAP posted to the registry

ScaleMEGA

A very large study, international in scope: 9,500 participants (target), run at 493 sites, across 2 countries.

How this score is built

Enrolment38/40
9,500 participants (target)
Site count25/25
485 sites
Country count7/15
2 countries
Planned duration10/10
Planned over about 532 months
Sponsor scale6/10
NRG Oncology has led 49 trials in our corpus

Investigator standingUNKNOWN

We have no verifiable track record for the investigator named on this trial. That is common for early-career investigators and for records held outside ClinicalTrials.gov — it is not a negative signal.

How this score is built

Investigator standing0/100
No investigator recorded in the registry for this trial

These describe the registry record only, and today we hold ClinicalTrials.gov data. Absent fields lower a score, and absence often reflects registration practice rather than study quality. A high-stature trial is not necessarily safer or a better choice for you — enrolling in a large definitive trial can mean a higher chance of receiving placebo, while a small early-phase study may be the only route to a new therapy.

Résumé

Colorectal cancer (CRC) is the fourth most common cancer and the second leading cause of cancer death among men and women in the United States (US). The lifetime risk of colorectal cancer in both men and women in the US is approximately 6%. About 93% of colorectal cancer (CRC) diagnoses are in patients older than 50 years (Siegel 2014). Randomized controlled trials show that screening for CRC significantly decreases CRC incidence and mortality (Schoen 2012, Atkin 2010, Mandel 1999, Mandel 2000). CRC screening has received a Grade A recommendation from the US Preventive Services Task Force. In the U.S., colonoscopy is the most utilized screening modality for CRC. On a population basis, screening rates, which were around 40-50%, have now increased to 65%, and a goal to increase to 80% compliance is being promoted (CDC 2011, CDC 2013, Meester 2015). Adenomatous polyps are the acknowledged precursors of colorectal cancer. Identification and removal of adenomas is the mechanism by which screening is effective in reducing CRC incidence and subsequent mortality. "Advanced" adenomas are adenomas which are greater than or equal to 1 cm, or have a "villous" component (tubulovillous or villous), or have foci of high grade dysplasia. Advanced adenomas are associated with increased long-term risk of cancer, even years after colonoscopy (Click 2018). The prevalence of advanced adenomas at screening colonoscopy is 5-10% (Ferlitsch 2011, Imperiale 2014). Non-advanced adenomas are adenomas greater than 1 cm with neither villous components nor high grade dysplasia. Non-advanced adenomas are much more common than advanced adenomas, present in around 30% of colonoscopy exams (Ferlitsch 2011, Imperiale 2014). After detection of adenomas, patients are advised to return periodically for surveillance colonoscopy. Patients with 1-2 non-advanced adenomas are recommended by guidelines to return in 5 - 10 years for follow-up surveillance colonoscopy (Lieberman 2012). However, there are no guidelines on how to triage individuals to 5 as opposed to 10 years. Furthermore, there is limited evidence supporting the effectiveness of surveillance colonoscopy in reducing CRC incidence. A retrospective study in patients with advanced adenomas demonstrated benefit (Atkin 2017), but the study was not randomized and did not include patients with 1-2 non-advanced adenomas. The only randomized trial of surveillance colonoscopy was reported in the early 1990's, when participants were randomized to 3 vs. 1- and 3- year surveillance (Winawer 1993). No difference in advanced adenoma detection was observed when comparing participants examined at the two screening intervals, and as a result, guidelines were modified with participants advised to return every 3 years after adenomatous polyp detection. The recommended interval for non-advanced adenomas was gradually lengthened to the current standard, but there is no randomized, controlled data to support that interval. Furthermore, observational data of surveillance colonoscopy practice in the U.S. demonstrate that recommended intervals are often not adhered to, and individuals return for repeat testing well ahead of guideline recommendations (Schoen 2010, Lieberman 2014). Furthermore, if anything, retrospective, natural history studies of non-advanced adenomas do not support the association of non-advanced adenoma with a higher risk of subsequent colorectal cancer (Atkin 1992, Spencer 1984, Loberg 2014). For example, in a classic study from the United Kingdom, patients with small rectosigmoid adenomas, even if multiple, did not have an increased risk of CRC compared to the general population, over a 14-year mean follow-up time (Atkin 1992). In a recent observational study from Norway, participants with a low-risk adenoma followed over a median of 7.7 years (maximum 19 years) without subsequent surveillance colonoscopy, had a lower CRC mortality than the general population (Loberg 2014), implying that although the initial colonoscopy may be protective, subsequent follow-up colonoscopy was not required. More recently, several studies have reported that individuals with non-advanced adenomas do not have an increased risk of colorectal cancer compared to those with no adenomas (Click 2018, Lieberman 2019, Lee 2019). Another recent major development affecting screening is that practitioners of colonoscopy are now recommended to monitor and insure their adenoma detection rates are high. Data from Poland (Kaminski 2010) and Kaiser Permanente in California (Corley 2014) have demonstrated that a higher adenoma detection rate (ADR) is associated with a lower long-term risk of interval CRC, or cancer occurring after colonoscopy. Our understanding of these observations is premised on the notion that leaving pre-neoplastic tissue (adenomas) in situ, (such as what occurs with a lower ADR), increases the chance that an adenoma left behind will subsequently transform into cancer. The concern over interval cancers has stimulated quality concerns about the practice of colonoscopy. Guidelines for a recommended ADR at screening colonoscopy are rising, from the initial targets of 15% in women and 25% in men (Lieberman 2012) to 20% in women and 30% in men or 25% overall. ADRs in clinical studies are now commonly over 30% and some practitioners report rates exceeding 50%. However, adenomas that are detected when the ADR is high or as it increases over time are generally small, non-advanced adenomas. Current clinical practice favoring colonoscopy-based screening with increased emphasis on detection of adenomas, most of which will turn out to be small, non-advanced adenomas, will greatly increase demand for utilization of surveillance colonoscopy exams in the coming decades. Yet, the evidence for determining the benefit, optimal timing, and recommended frequency of surveillance colonoscopy is unknown. A randomized, clinical trial to demonstrate the difference in yield between 5- or 10-year surveillance for participants with non-advanced adenoma is needed to guide clinical practice. Only a randomized trial will be authoritative enough to define good clinical practice and directly influence clinical care.

Affections

Adenocarcinoma of the Colon
Adenocarcinoma of the Rectum

Éligibilité

Éligibilité
Sexe	Tous
Âges	45 Years – 70 Years
Volontaires sains	Non

Éligibilité telle qu'elle figure dans le registre

Inclusion Criteria: * The participant must have signed and dated an IRB-approved consent form that conforms to federal and institutional guidelines. * Participants greater than or equal to 45 and less than 70 years of age at the time of colonoscopy. * Participants with a first-time diagnosis of 1-2 non-advanced tubular adenomas (less than 10 mm without tubulovillous or villous changes or high grade or severe dysplasia) from the qualifying colonoscopy within 4 years prior to randomization. * Sessile serrated polyps/adenomas, as long as they do not meet the criteria for advanced adenomas, will be considered as non-advanced adenomas. * Qualifying colonoscopy must be a complete colonoscopy with visualization of the cecum and with adequate cleansing within 4 years prior to randomization. * Complete excision of all observed polyps in qualifying colonoscopy * Participants must be able to read or understand English or Spanish. Exclusion Criteria: * • Prior history of colorectal cancer or colorectal adenomas including sessile serrated polyps/adenomas excluding those found on the qualifying colonoscopy. * Prior history of a hyperplastic polyp measuring greater than or equal to 1 cm in size. * Traditional serrated adenomas found on the qualifying colonoscopy. * Hyperplastic polyp measuring greater than or equal to 1 cm in size found on the qualifying colonoscopy. * Previous malignancies unless the patient has been disease-free for 5 or more years prior to randomization and is deemed by the physician to be at low risk for recurrence. Patients with the following cancers are eligible if diagnosed and treated within the past 5 years: all in situ cancers and basal cell and squamous cell carcinoma of the skin. * Colonoscopy performed after the qualifying colonoscopy but prior to randomization. * Incomplete qualifying colonoscopy (e.g., cecum not visualized). * Incomplete endoscopic excision of adenomatous polyps based on colonoscopist impression at qualifying colonoscopy. (Excision of all hyperplastic rectosigmoid polyps is not required.) * Sub-total colectomy or total proctocolectomy. (Segmental resections are allowed.) * Family history of CRC diagnosed at less than or equal to 60 years of age in a first degree relative (mother, father, child, sibling) or in two first degree relatives with CRC at any age. * Participants with a clinical diagnosis of a significant heritable risk for colorectal cancer (Familial Adenomatous Polyposis, Hereditary Nonpolyposis Colorectal Cancer \[Lynch Syndrome\]). * Participants tested positive for a Familial Adenomatous Polyposis, Hereditary Nonpolyposis Colorectal Cancer \[Lynch Syndrome\] genetic mutation that increases risk of colorectal cancer. * Inflammatory bowel disease (e.g., Crohn's Disease, ulcerative colitis). * Life expectancy less than 10 years due to comorbid conditions in the opinion of the investigator. * Other comorbid conditions that would prevent the participant from having colonoscopies or would prevent required follow-up.

Éligibilité en énoncés simples

Les critères de cette fiche n'ont pas encore été décomposés en énoncés distincts. Le texte du registre ci-dessus est complet et fait foi.

Conception de l'étude

Conception de l'étude
Type d'étude	Interventionnelle
Phase	Sans objet
Répartition	Randomisée
Modèle d'intervention	PARALLEL
Objectif principal	OTHER
Insu	NONE (0)
Recrutement	9 500 participants recherchés

Promoteur et collaborateurs

NRG Oncology Promoteur
National Cancer Institute (NCI) Collaborateurs

Groupes et interventions

Arm 1EXPERIMENTAL
5-Year and 10-Year Surveillance Colonoscopy after Qualifying Colonoscopy
Arm 2EXPERIMENTAL
10-Year Surveillance Colonoscopy after Qualifying Colonoscopy

Interventions

Intervention 5-year and 10 Year Surveillance Colonoscopy after Qualifying Colonoscopy
The five- and ten-year colonoscopies, in addition to any unscheduled colonoscopies, will be performed according to currently accepted guidelines for the performance of quality colonoscopy. Participants will be given the standardized colonoscopy preparation instructions per institutional standards.

Critères de jugement

Critère de jugement principal
Incidence of colorectal cancer
To examine colorectal cancer incidence in participants with 1 to 2 non-advanced adenomas randomized to surveillance colonoscopy at 10 years compared to participants randomized to surveillance colonoscopy at 5 and 10 years.
Délai 10 years
Autre critère de jugement
Incidence of advanced adenoma
To examine advanced adenoma incidence in participants with 1 to 2 non-advanced adenomas randomized to surveillance colonoscopy at 10 years compared to participants randomized to surveillance colonoscopy at 5 and 10 years.
Délai 10 years
Autre critère de jugement
Colorectal cancer mortality
To examine colorectal cancer mortality in participants with 1 to 2 non-advanced adenomas randomized to surveillance colonoscopy at 10 years compared to participants randomized to surveillance colonoscopy at 5 and 10 years.
Délai 10 years
Autre critère de jugement
Incidence of stage III-IV colorectal cancer
To examine stage III-IV colorectal cancer incidence in participants with 1 to 2 non-advanced adenomas randomized to surveillance colonoscopy at 10 years compared to participants randomized to surveillance colonoscopy at 5 and 10 years.
Délai 10 years

Dates

Dates
Date de début	9 février 2022 (réelle)
Achèvement principal	1 novembre 2035 (estimée)
Achèvement	1 novembre 2065 (estimée)
Première publication	18 octobre 2021 (réelle)
Dernière mise à jour	2 septembre 2026
Résultats publiés	Non précisé dans la fiche du registre
Statut vérifié pour la dernière fois	septembre 2026

Réelle signifie que l'événement a eu lieu. Estimée signifie que le promoteur s'y attend. Les deux ont un sens différent.

Lieux

343 sites sont en recrutement

Puerto Rico

Puerto Rico
Établissement	Ville	Statut
Cancer Center-Metro Medical Center Bayamon	Bayamón	En recrutement
Puerto Rico Hematology Oncology Group	Bayamón	En recrutement
HIMA San Pablo Oncologic Hospital	Caguas	Suspendu
Pan American Center for Oncology Trials LLC - Dorado	Dorado	En recrutement
Doctors Cancer Center	Manati	En recrutement
Pan American Center for Oncology Trials LLC - Manati	Manati	En recrutement
Instituto Oncologia Moderna Ponce	Ponce	Suspendu
Pan American Center for Oncology Trials LLC - Ciudadela	San Juan	En recrutement
Primary Care Physician Group	San Juan	Suspendu
PROncology	San Juan	En recrutement
San Juan City Hospital	San Juan	En recrutement
San Juan Community Oncology Group	San Juan	En recrutement
Centro Comprensivo de Cancer de UPR	San Juan	En recrutement
Pan American Center for Oncology Trials LLC	San Juan	En recrutement
San Juan Veterans Affairs Medical Center	San Juan	En recrutement

United States

United States
Établissement	Ville	État ou région	Statut
Riverwood Healthcare Center	Aitkin	Minnesota	En recrutement
University of New Mexico Cancer Center	Albuquerque	New Mexico	En recrutement
Lovelace Medical Center-Saint Joseph Square	Albuquerque	New Mexico	Suspendu
Saint Luke's Cancer Center - Allentown	Allentown	Pennsylvania	En recrutement
OSF Saint Anthony's Health Center	Alton	Illinois	En recrutement
Community Hospital of Anaconda	Anaconda	Montana	En recrutement
Kaiser Permanente-Anaheim	Anaheim	California	En recrutement
University of Michigan Rogel Cancer Center	Ann Arbor	Michigan	Actif, sans recrutement
Ascension Northeast Wisconsin-Saint Elizabeth Cancer Center-Appleton	Appleton	Wisconsin	Actif, sans recrutement
PCR Oncology	Arroyo Grande	California	En recrutement
Mission Hope Medical Oncology - Arroyo Grande	Arroyo Grande	California	En recrutement
Duluth Clinic Ashland	Ashland	Wisconsin	En recrutement
Northwest Wisconsin Cancer Center	Ashland	Wisconsin	En recrutement
Piedmont Hospital	Atlanta	Georgia	Actif, sans recrutement
Augusta University Medical Center	Augusta	Georgia	En recrutement
Rocky Mountain Regional VA Medical Center	Aurora	Colorado	En recrutement
Rush-Copley Medical Center	Aurora	Illinois	Actif, sans recrutement
UCHealth University of Colorado Hospital	Aurora	Colorado	En recrutement
Rocky Mountain Cancer Centers-Aurora	Aurora	Colorado	Actif, sans recrutement
Mount Sinai Comprehensive Cancer Center at Aventura	Aventura	Florida	En recrutement
Saint Alphonsus Cancer Care Center-Baker City	Baker City	Oregon	Suspendu
Kaiser Permanente-Baldwin Park	Baldwin Park	California	En recrutement
Mercy Oncology and Hematology - Clayton-Clarkson	Ballwin	Missouri	En recrutement
Kaiser Permanente-Woodlawn Medical Center	Baltimore	Maryland	En recrutement
CommonSpirit Saint Joseph Hospital - Bardstown	Bardstown	Kentucky	En recrutement
Bronson Battle Creek	Battle Creek	Michigan	En recrutement
Essentia Health - Baxter Clinic	Baxter	Minnesota	En recrutement
Bay Pines VA Healthcare System	Bay Pines	Florida	En recrutement
UHHS-Chagrin Highlands Medical Center	Beachwood	Ohio	En recrutement
Beaufort Memorial Hospital	Beaufort	South Carolina	En recrutement
Indu and Raj Soin Medical Center	Beavercreek	Ohio	Actif, sans recrutement
Kaiser Permanente-Bellflower	Bellflower	California	En recrutement
Sanford Joe Lueken Cancer Center	Bemidji	Minnesota	En recrutement
Saint Luke's University Hospital-Bethlehem Campus	Bethlehem	Pennsylvania	En recrutement
Billings Clinic Cancer Center	Billings	Montana	En recrutement

443 sites supplémentaires sont indiqués dans la fiche du registre.

Documents de l'étude

Aucun document n'est lié dans cette fiche du registre.

Évolution au fil du temps

2 septembre 2026
Site ajouté
8 sites added (493 total)
485493

Registre: ClinicalTrials.gov · NCT########

https://xmedica.io/trials/ctgov/NCT05080673