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Colorectal CancerNCT01741363

Screening for Stomach Diseases and Colorectal Neoplasms With the Fecal Testing

A study testing FIT(Eiken OC-Sensor) Two-day sampling, FIT(Eiken OC-Sensor) One-year interval and FIT(Eiken OC-Sensor) One-day sampling in people with Colorectal Cancer and Stomach Disease, run by National Taiwan University Hospital at 1 site in Taiwan.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

1. The abundant results from this trial will be helpful for assessing the feasibility of increasing stool sampling and shortening screening interval in population setting for lower and upper gastrointestinal tract lesions, their long-term effects, and the respective cost-effectiveness. 2. Read more about this study

Who is it for?
Ages 50 to 69 yearsHealthy volunteers can take part
Conditions the study is for
Colorectal Cancer, Stomach Disease
What is being tested?
FIT(Eiken OC-Sensor) Two-day sampling, FIT(Eiken OC-Sensor) One-year interval and FIT(Eiken OC-Sensor) One-day sampling
Could I receive a placebo?
No, everyone receives an active treatment
How many people
99,314 participants
Where
1 siteTaiwan
Study dates
1 Jan 2014to 31 Dec 2020
Phase
Interventional
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 50 to 69 years
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • 50 to 69 years average-risk subjects for FIT
  • 50 to 69 years subjects for HpSA

Who cannot join

  • Subjects who are unwilling to participate
  • Subjects ineligible for colonoscopy (for the one-day vs two day FIT screening)
  • Subjects with a history of total gastrectomy
  • Pregnancy
  • Subjects with severe illnesses
  • Subjects with prior participation in the pilot program

Trial locations and contacts

1 site in 1 country.

Taiwan1 site
  • National Taiwan University Hospital

    Taipei, 10002

Other trials in Taiwan

About this study

Official title: Screening for Stomach Diseases and Colorectal Neoplasms With the Fecal Testing: a Population-based Randomized Study

  1. The abundant results from this trial will be helpful for assessing the feasibility of increasing stool sampling and shortening screening interval in population setting for lower and upper gastrointestinal tract lesions, their long-term effects, and the respective cost-effectiveness.
  2. The study will evaluate the value of population-based screen and treatment for H. pylori infection when the HPSA is combined with the FIT.
Read the detailed description

Growing body of evidences have shown that fecal immunochemical test (FIT) outperform guaiac fecal occult blood test (gFOBT) in terms of sensitivity, neoplasm detection rate and public participation. Though direct outcome evidence is still lacking for FIT, it is anticipated to have higher colorectal cancer (CRC) mortality and incidence reduction compared with gFOBT. In Taiwan, nation-wide CRC screening program has been launched since the year of 2004 ,which provides biennial FIT screening for adults aged 50 to 69 years. Currently available data from the Bureau of Health Promotion has shown a significant stage-shift effect, an early indicator of screening effectiveness, by this screening program.

Nevertheless, the aforementioned advantages of FIT, missed neoplasms and interval cancer still exists under the current one-day stool sampling method with biennial screening interval, which might affect the effectiveness of overall screening program. Increase the number of stool samples or shortening of screening interval may be helpful for early detection of clinically significant neoplasms but it remains unclear whether such an approach may lower the screenee compliance or public participation. Moreover, its impact on the demand of confirmatory colonoscopy and cost-effectiveness of the whole screening program is still largely unknown and need to be further investigated.

In this study, we firstly aim to randomly allocate screening attendee to one of the following four arms: one-day sampling with annual screening, one-day sampling with biennial screening, two-day sampling with annual screening, and two-day sampling with biennial screening. Participation rate, positive rates of FIT, detection rate for neoplasms, positive predictive value, and long-term outcome including cancer incidence and mortality will be calculated and compared among four groups.

Secondly, in the Taiwanese population, which is a typical presentation of Asian populations, although the incidence of colorectal cancer is rapidly increasing, Helicobacter pylori-related upper gastrointestinal pathologies remain highly prevalent, which may imply that mass screening solely based on FIT could be insufficient as significant upper GI pathologies can be missed. Since the FIT does not predict upper GI pathologies, the adjunct of an「Helicobacter pylori stool-antigen test (HpSA) 」 may be a potential candidate to realize a pan-detecting assay based on stool samples in a population in which both lower and upper GI lesions are equally prevalent. Therefore, in the present study, we will also evaluate the value of simultaneous FIT and HpSA test in the community-based mass screening. We invited subjects in a randomized study to receive the FIT or the FIT plus HPSA. Those who are tested positive for HPSA will receive upper endoscopic examination and anti-H. pylori treatment. For the short-term indicators, we will evaluate the participation rate and diagnostic yield when the HPSA is added. For the long-term indicators, we will compare the incidence and mortality of gastric cancer as well as complicated peptic ulcers.

To summary, this study includes two randomized trials:

  1. To make a comparison between one-day sampling with annual screening, one-day sampling with biennial screening, two-day sampling with annual screening, and two-day sampling with biennial screening using FIT;
  2. To make a comparison between FIT plus HpSA and FIT alone for screening.

Finally, the cost-effectiveness analysis will be also conducted using previously established Markov model of CRC natural history and stomach diseases (such as dyspepsia, peptic ulcer disease, and gastric cancer) using the results ascertained from this trial. The primary outcomes were gastric cancer incidence and mortality rates as well as colorectal cancer incidence and mortality rates.

Being tested
FIT(Eiken OC-Sensor) Two-day sampling, FIT(Eiken OC-Sensor) One-year interval, FIT(Eiken OC-Sensor) One-day sampling, FIT(Eiken OC-Sensor) Two-year interval, HpSA (Firstep Helicobacter pylori Antigen Rapid Test)
Keywords
iFOBT, one-day sample, two-day sample, Helicobacter pylori stool antigen
Medical subject headings
Colorectal Neoplasms, Stomach Diseases

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • FIT(Eiken OC-Sensor) Two-day samplingOther

    Collect two stool samples in two separate days

  • FIT(Eiken OC-Sensor) One-year intervalOther

    Screening with one-year interval

  • FIT(Eiken OC-Sensor) One-day samplingOther

    One-day sampling

  • FIT(Eiken OC-Sensor) Two-year intervalOther

    Screening with two-year interval

  • HpSA (Firstep Helicobacter pylori Antigen Rapid Test)Other

    HpSA for detection of upper gastrointestinal diseases; screen and treat for H. pylori infection. Upper endoscopy for H. pylori carriers. HPSA+FIT compared with FIT alone.

  • FIT onlyOther

    HPSA+FIT compared with FIT alone.

Study groups in NCT01741363
Study groupRoleWhat they receive
one-day sampling with one-year intervalExperimentalFIT one-day sampling with one-year interval
Receives: Other: FIT(Eiken OC-Sensor) One-year interval; Other: FIT(Eiken OC-Sensor) One-day sampling
one-day sampling with two-year intervalActive comparatorFIT one-day sampling with two-year interval
Receives: Other: FIT(Eiken OC-Sensor) One-day sampling; Other: FIT(Eiken OC-Sensor) Two-year interval
two-day sampling with one-year intervalExperimentalFIT two-day sampling with one-year interval
Receives: Other: FIT(Eiken OC-Sensor) Two-day sampling; Other: FIT(Eiken OC-Sensor) One-year interval
two-day sampling with two-year intervalExperimentalFIT two-day sampling with two-year interval
Receives: Other: FIT(Eiken OC-Sensor) Two-day sampling; Other: FIT(Eiken OC-Sensor) Two-year interval
Hp stool antigen (HpSA)+FITExperimentalHpSA for detection of upper gastrointestinal tract diseases and upper endoscopy for H. pylori carriers; HPSA combined with FIT
Receives: Other: FIT(Eiken OC-Sensor) One-day sampling; Other: FIT(Eiken OC-Sensor) Two-year interval; Other: HpSA (Firstep Helicobacter pylori Antigen Rapid Test)
FIT onlyActive comparatorHpSA + FIT compared with FIT alone
Receives: Other: FIT(Eiken OC-Sensor) One-day sampling; Other: FIT(Eiken OC-Sensor) Two-year interval; Other: FIT only

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Incidence of Stomach Cancer

    Number of incident stomach cancer

    The recruitment period of participants was from January 1, 2014 to September 27, 2018. Final follow-up occurred December 31, 2020.

    For outcome measurement, the average follow-up time of the study participants was 5.5 years.

    Measured: 5.5 years

  2. Mortality of Stomach Cancer

    Number of stomach cancer death

    The recruitment period of participants was from January 1, 2014 to September 27, 2018. Final follow-up occurred December 31, 2020.

    For outcome measurement, the average follow-up time of the study participants was 5.5 years.

    Measured: 5.5 years

Secondary outcomes (2)
  1. Mortality of Colorectal Cancer

    Number of colorectal cancer death

    The recruitment period of participants was from January 1, 2014 to September 27, 2018. Final follow-up occurred December 31, 2020.

    For outcome measurement, the average follow-up time of the study participants was 5.5 years.

    Measured: 5.5 years

  2. Incidence of Colorectal Cancer

    Number of incident colorectal cancer

    The recruitment period of participants was from January 1, 2014 to September 27, 2018. Final follow-up occurred December 31, 2020.

    For outcome measurement, the average follow-up time of the study participants was 5.5 years.

    Measured: 5.5 years

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted4 Dec 2012 (estimated)
  2. Study start1 Jan 2014
  3. Primary completion31 Dec 2020
  4. Study completion31 Dec 2020

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Prevention
Allocation
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
99,314 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01741363
Sponsor's protocol ID
201205030RIB
Status last verified
Oct 2018
First submitted
5 Oct 2012
Last updated
21 Nov 2024
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Lee YC, Liu JH, Mulder DT, Yang JY, Chiang TH, Hsu WF, Chiu HM, Su WW, Chou KC, Chen SL, Fann JC, Chiu SY, Chuang SL, Chen YR, Chu TC, Chang MY, Chen ST, Hu TH, Fang YJ, Liou JM, Wu MS, Yeh YP, Hur C, Yen AM, Chen TH; Collaborators of the Taiwan Community-Based Integrated Screening Group. Cost-Effectiveness of Fecal Immunochemical Testing Alone vs Co-Testing With Helicobacter pylori Stool Antigen. JAMA. 2026 Jul 7;336(1):35-46. doi: 10.1001/jama.2026.6908.

    PubMed 42223961
  • Lee YC, Chiang TH, Chiu HM, Su WW, Chou KC, Chen SL, Yen AM, Fann JC, Chiu SY, Chuang SL, Chen YR, Chen SD, Hu TH, Fang YJ, Wu MS, Chen TH, Yeh YP; Collaborators of Taiwan Community-based Integrated Screening Group. Screening for Helicobacter pylori to Prevent Gastric Cancer: A Pragmatic Randomized Clinical Trial. JAMA. 2024 Nov 19;332(19):1642-1651. doi: 10.1001/jama.2024.14887.

    PubMed 39348147
  • Lee YC, Chiang TH, Chiu HM, Wu MS, Yeh YP, Hsiu-Hsi Chen T; Collaborators of the Taiwan Community-Based Integrated Screening Group. Community-Based Gastric Cancer Screening Coupled With a National Colorectal Cancer Screening Program: Baseline Results. Gastroenterology. 2021 May;160(6):2159-2161.e4. doi: 10.1053/j.gastro.2021.01.008. Epub 2021 Jan 11. No abstract available.

    PubMed 33444571

Questions about this trial

What is this clinical trial studying?

A study testing FIT(Eiken OC-Sensor) Two-day sampling, FIT(Eiken OC-Sensor) One-year interval and FIT(Eiken OC-Sensor) One-day sampling in people with Colorectal Cancer and Stomach Disease, run by National Taiwan University Hospital at 1 site in Taiwan.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 2 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 21 Nov 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Taiwan. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Yes. Results are posted in the registry (first posted 21 Nov 2024). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Incidence of Stomach Cancer (time frame: 5.5 years). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT01741363, which also lists 3 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 21 Nov 2024.

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