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Colorectal CancerNCT04967183

Polyprev: Study to Compare Fecal Immunochemical Test With Endoscopic Surveillance After Advanced Adenoma Resection in Fecal Immunochemical Test Colorectal Cancer Screening Programs.

A study testing Annual FIT and Endoscopic surveillance. in people with Colorectal Cancer, run by Fundacin Biomedica Galicia Sur at 1 site in Spain.

Active, not recruiting

Under way, not looking for participants. Everyone needed has enrolled. The study is still running.

Official record
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Trial summary

Colorectal cancer (CRC) screening programs have been implemented to reduce the burden of the disease. When an advanced colonic lesions is detected, it is recommended to perform endoscopic surveillance with different intervals between explorations. Read more about this study

Who is it for?
Ages 50 to 65 yearsHealthy volunteers can take part
Conditions the study is for
Colorectal Cancer
What is being tested?
Annual FIT and Endoscopic surveillance.
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
3,788 participants
Where
1 siteSpain
Study dates
1 Jun 2022to Jun 2035
Phase
Interventional
Are there results?
Not yet: the study is under way

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 65 years
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • Individuals aged 50 to 65 years.
  • Individuals with at least one advanced adenoma (tubulovillous or villous histology, high grade dysplasia or ≥ 10mm), and / or at least three non-advanced adenomas detected and resected completely within the population-based CRC screening program.

Who cannot join

  • Personal history of CRC.
  • Colonic lesion ≥10mm resected without histological diagnosis.
  • More than 10 adenomas in baseline colonoscopy.
  • Serrated polyposis syndrome.
  • Two or more first-degree relatives with CRC.
  • Hereditary predisposition to CRC.
Show all 10Show fewer
  • Relevant comorbidity with life expectancy inferior to 5 years.
  • Colonoscopy with incomplete mucosal examination.
  • Incomplete resection of baseline lesions.
  • Non-acceptance after reading the informed consent.

Trial locations and contacts

1 site in 1 country.

Spain1 site
  • Complexo Hospitalario Universitario de Ourense

    Ourense, Ourense, 32002

Other trials in Spain

About this study

Official title: Polyprev Study: Randomized, Multicenter, Controlled Trial Comparing Fecal Immunochemical Test With Endoscopic Surveillance After Advanced Adenoma Resection in Fecal Immunochemical Test Colorectal Cancer Screening Programs.

Colorectal cancer (CRC) screening programs have been implemented to reduce the burden of the disease. When an advanced colonic lesions is detected, it is recommended to perform endoscopic surveillance with different intervals between explorations. Although the reduction in CRC incidence, endoscopic surveillance is producing a considerable increase in the number of colonoscopies. However, participation in CRC screening programs based on the fecal immunochemical test (FIT) could be a non inferior alternative to endoscopic surveillance.

Based on this hypothesis, the research group have designed a randomized clinical trial within the population CRC screening programs to compare FIT surveillance to endoscopic surveillance in patients with advanced lesions resected.

Read the detailed description

Colorectal cancer (CRC) is one of the most common malignancies in western countries. CRC screening programs have been implemented in order to reduce the burden of the disease. Screening programs in Spain are based on the biennial detection of fecal hemoglobin with a fecal immunochemical test (FIT) and a diagnostic colonoscopy if positive. The detection of at least one advanced adenoma or serrated lesion defines a high risk situation for metachronous CRC. This group of patients is recommended to perform endoscopic surveillance with different intervals between explorations. Endoscopic surveillance reduces mortality only 1.7% and increases the number of colonoscopies by 62% with an additional cost of € 68,000 for an increase of 0.9 years of life. Moreover, colonoscopy is a procedure associated with potentially serious side effects.

A recently British study shows that with a cut-off of 10 µg/g, FIT has a higher sensitivity and specificity for CRC with a significant cost reduction compared to colonoscopy surveillance. Additionally, most of the population prefers non-invasive faecal tests rather than colonoscopy.

Based on this evidence, the research group have designed a multicenter, randomized clinical trial to compare the 10 year CRC incidence after resection of advanced colonic lesions detected within CRC screening programs between endoscopic surveillance and participation in CRC screening programs based on FIT.

Apart from this purpose, the investigators will also assess the values and preferences regarding surveillance and risk of CRC. Further, the research group will evaluate the relationship between Mediterranean diet and physical activity with the detection of advanced adenomas and CRC.

Being tested
Annual FIT, Endoscopic surveillance.
Keywords
Screening program, Endoscopic surveillance, Fecal immunochemical test, Mediterranean diet, Physical activity
Medical subject headings
Colorectal Neoplasms, Motor Activity

What participants receive

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

  • Annual FITDiagnostic test

    Patients will be offered an annual FIT and colonoscopy will be performed if fecal hemoglobin concentration is ≥10µg / g of feces. After performing a colonoscopy the FIT will be sent to the patient:

    • After one year if the unscheduled colonoscopy has been incomplete or a lesion requiring endoscopic surveillance has been completely resected.
    • After five years if the colonoscopy has evaluated the entire mucosa, it is normal or with lesions that do not require endoscopic surveillance (1-2 non-advanced adenomas).
  • Endoscopic surveillance.Procedure or surgery

    First surveillance colonoscopy will be performed in three-year time. If an advanced adenoma or at least three non-advanced adenomas are detected, colonoscopy will be repeated after 3 years. In contrast, if colonoscopy is normal or 1-2 non-advanced adenomas are detected, colonoscopy will be repeated after 5 years.

Study groups in NCT04967183
Study groupRoleWhat they receive
Group IExperimentalAnnual FIT surveillance
Receives: Diagnostic Test: Annual FIT
Group IIActive comparatorEndoscopic surveillance
Receives: Procedure: Endoscopic surveillance.

What is being measured

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

  1. Rate of invasive CRC

    It is the main outcome of the study. Invasive CRC is defined as colonic adenocarcinoma that invades the submucosa. Adenocarcinomas in situ and intramucosal carcinomas will not be considered as invasive CRC.

    Measured: 10 years

  2. Rate of interval CRC

    Interval CRC is defined as the CRC detected between two organized surveillance (FIT or colonoscopy).

    Measured: 10 years

  3. Mortality

    The deaths and their cause will be collected: associated with CRC, associated with adverse effects of screening or unrelated.

    Measured: 10 years

  4. Rate of advanced colonic lesions

    Advanced colonic lesions will be defined as advanced adenomas (at least 10mm, hairy histology or high grade dysplasia) or advanced serrated lesions (at least 10mm or with dysplasia).

    Measured: 10 years

  5. Frequency of participation in the surveillance strategy

    According to the methodology of the information systems of the screening programs, three categories will be defined: non-participation, irregular participation, regular participation.

    Measured: 10 years

  6. Adverse effects

    Adverse effects associated with surveillance are defined as complications that require hospitalization. Those related to the surgical treatment of benign colonic lesions will be included as adverse effects.

    Measured: 10 years

Secondary outcomes (4)
  1. CRC, adenoma and advanced serrated lesions at three years

    Detection of CRC, adenoma and advanced serrated lesion will be collected at 3 years of follow-up.

    Measured: 3 years

  2. Physical activity

    We will use the International Physical Activity. Questionnaire (IPAQ) to mesure physical activity.

    Measured: 3 years

  3. Mediterranean lifestyle

    We will use the Mediterranean Lifestyle index (MEDLIFE) to measure overall adherence to the Mediterranean lifestyle.

    Measured: 3 years

  4. Preferences of the subjects

    We will use a survey with vignette questions to evaluate the values and preferences of the subjects regarding surveillance.

    Measured: 2 years

Timeline

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

  1. First posted19 Jul 2021
  2. Study start1 Jun 2022
  3. Primary completion12 Apr 2026
  4. Study completionJun 2035 (estimated)

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
Screening
Allocation
Randomised
Intervention model
Parallel groups
Model description
Patients will be identified in population CRC secreening programs of Galicia, the Basque Country, the Region of Valencia and Murcia. We will considered individuals aged 50 to 65 years with at least one advanced adenoma (tubulovillous or villous histology, high grade dysplasia or ≥ 10mm), and / or at least three non-advanced adenomas detected and resected completely within the population-based CRC screening program. Patients will be randomly allocated to perform an annual FIT and colonoscopy if fecal hemoglobin concentration is ≥10µg/g, or to perform endoscopic surveillance. Patients will be also stratified into two groups: ≥5 adenomas or an adenoma ≥20mm and the rest of patients. Patients will be followed for a period of 10 years.
Masking
Triple blind
Who is masked
Participant, Care provider, Investigator
Enrolment
3,788 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04967183
Sponsor's protocol ID
POLYPREV
Status last verified
Feb 2026
First submitted
8 Jul 2021
Last updated
3 Sep 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No

Publications

  • Holleczek B, Rossi S, Domenic A, Innos K, Minicozzi P, Francisci S, Hackl M, Eisemann N, Brenner H; EUROCARE-5 Working Group:. On-going improvement and persistent differences in the survival for patients with colon and rectum cancer across Europe 1999-2007 - Results from the EUROCARE-5 study. Eur J Cancer. 2015 Oct;51(15):2158-2168. doi: 10.1016/j.ejca.2015.07.024. Epub 2015 Sep 26.

    PubMed 26421819
  • Atkin WS, Valori R, Kuipers EJ, Hoff G, Senore C, Segnan N, Jover R, Schmiegel W, Lambert R, Pox C; International Agency for Research on Cancer. European guidelines for quality assurance in colorectal cancer screening and diagnosis. First Edition--Colonoscopic surveillance following adenoma removal. Endoscopy. 2012 Sep;44 Suppl 3:SE151-63. doi: 10.1055/s-0032-1309821. Epub 2012 Sep 25.

    PubMed 23012119
  • Bretthauer M, Loberg M, Kalager M. Long-term colorectal-cancer mortality after adenoma removal. N Engl J Med. 2014 Nov 20;371(21):2036-7. doi: 10.1056/NEJMc1411954. No abstract available.

    PubMed 25409378
  • Zauber AG, Winawer SJ, O'Brien MJ, Lansdorp-Vogelaar I, van Ballegooijen M, Hankey BF, Shi W, Bond JH, Schapiro M, Panish JF, Stewart ET, Waye JD. Colonoscopic polypectomy and long-term prevention of colorectal-cancer deaths. N Engl J Med. 2012 Feb 23;366(8):687-96. doi: 10.1056/NEJMoa1100370.

    PubMed 22356322
  • Martinez ME, Baron JA, Lieberman DA, Schatzkin A, Lanza E, Winawer SJ, Zauber AG, Jiang R, Ahnen DJ, Bond JH, Church TR, Robertson DJ, Smith-Warner SA, Jacobs ET, Alberts DS, Greenberg ER. A pooled analysis of advanced colorectal neoplasia diagnoses after colonoscopic polypectomy. Gastroenterology. 2009 Mar;136(3):832-41. doi: 10.1053/j.gastro.2008.12.007. Epub 2008 Dec 9.

    PubMed 19171141
  • Hassan C, Quintero E, Dumonceau JM, Regula J, Brandao C, Chaussade S, Dekker E, Dinis-Ribeiro M, Ferlitsch M, Gimeno-Garcia A, Hazewinkel Y, Jover R, Kalager M, Loberg M, Pox C, Rembacken B, Lieberman D; European Society of Gastrointestinal Endoscopy. Post-polypectomy colonoscopy surveillance: European Society of Gastrointestinal Endoscopy (ESGE) Guideline. Endoscopy. 2013 Oct;45(10):842-51. doi: 10.1055/s-0033-1344548. Epub 2013 Sep 12.

    PubMed 24030244
  • Cubiella J, Carballo F, Portillo I, Cruzado Quevedo J, Salas D, Binefa G, Mila N, Hernandez C, Andreu M, Teran A, Arana-Arri E, Ono A, Valverde MJ, Bujanda L, Hernandez V, Morillas JD, Jover R, Castells A. Incidence of advanced neoplasia during surveillance in high- and intermediate-risk groups of the European colorectal cancer screening guidelines. Endoscopy. 2016 Nov;48(11):995-1002. doi: 10.1055/s-0042-112571. Epub 2016 Aug 2.

    PubMed 27485482
  • Mangas-Sanjuan C, Jover R, Cubiella J, Marzo-Castillejo M, Balaguer F, Bessa X, Bujanda L, Bustamante M, Castells A, Diaz-Tasende J, Diez-Redondo P, Herraiz M, Mascort-Roca JJ, Pellise M, Quintero E; Grupo de Cribado del Cancer Colorrectal de la Sociedad Espanola de Epidemiologia. Endoscopic surveillance after colonic polyps and colorrectal cancer resection. 2018 update. Gastroenterol Hepatol. 2019 Mar;42(3):188-201. doi: 10.1016/j.gastrohep.2018.11.001. Epub 2019 Jan 6. English, Spanish.

    PubMed 30621911
  • Zorzi M, Senore C, Turrin A, Mantellini P, Visioli CB, Naldoni C, Sassoli De' Bianchi P, Fedato C, Anghinoni E, Zappa M, Hassan C; Italian colorectal cancer screening survey group. Appropriateness of endoscopic surveillance recommendations in organised colorectal cancer screening programmes based on the faecal immunochemical test. Gut. 2016 Nov;65(11):1822-1828. doi: 10.1136/gutjnl-2015-310139. Epub 2015 Aug 21.

    PubMed 26297727
  • Lieberman DA, Holub J, Eisen G, Kraemer D, Morris CD. Utilization of colonoscopy in the United States: results from a national consortium. Gastrointest Endosc. 2005 Dec;62(6):875-83. doi: 10.1016/j.gie.2005.06.037.

    PubMed 16301030
  • Marzo-Castillejo M, Almeda J, Mascort JJ, Cunillera O, Saladich R, Nieto R, Pineiro P, Llagostera M, Cantero F, Segarra M, Puente D. Appropriateness of colonoscopy requests according to EPAGE-II in the Spanish region of Catalonia. BMC Fam Pract. 2015 Oct 26;16:154. doi: 10.1186/s12875-015-0369-8.

    PubMed 26498043
  • Greuter MJE, de Klerk CM, Meijer GA, Dekker E, Coupe VMH. Screening for Colorectal Cancer With Fecal Immunochemical Testing With and Without Postpolypectomy Surveillance Colonoscopy: A Cost-Effectiveness Analysis. Ann Intern Med. 2017 Oct 17;167(8):544-554. doi: 10.7326/M16-2891. Epub 2017 Oct 3.

    PubMed 28973514
  • Atkin W, Cross AJ, Kralj-Hans I, MacRae E, Piggott C, Pearson S, Wooldrage K, Brown J, Lucas F, Prendergast A, Marchevsky N, Patel B, Pack K, Howe R, Skrobanski H, Kerrison R, Swart N, Snowball J, Duffy SW, Morris S, von Wagner C, Halloran S. Faecal immunochemical tests versus colonoscopy for post-polypectomy surveillance: an accuracy, acceptability and economic study. Health Technol Assess. 2019 Jan;23(1):1-84. doi: 10.3310/hta23010.

    PubMed 30618357
  • Bonello B, Ghanouni A, Bowyer HL, MacRae E, Atkin W, Halloran SP, Wardle J, von Wagner C. Using a hypothetical scenario to assess public preferences for colorectal surveillance following screening-detected, intermediate-risk adenomas: annual home-based stool test vs. triennial colonoscopy. BMC Gastroenterol. 2016 Sep 13;16(1):113. doi: 10.1186/s12876-016-0517-1.

    PubMed 27618798
  • Craig CL, Marshall AL, Sjostrom M, Bauman AE, Booth ML, Ainsworth BE, Pratt M, Ekelund U, Yngve A, Sallis JF, Oja P. International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc. 2003 Aug;35(8):1381-95. doi: 10.1249/01.MSS.0000078924.61453.FB.

    PubMed 12900694

Questions about this trial

What is this clinical trial studying?

A study testing Annual FIT and Endoscopic surveillance. in people with Colorectal Cancer, run by Fundacin Biomedica Galicia Sur at 1 site in Spain.

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 10 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: under way, not looking for participants, as of the sponsor's last update on 3 Sep 2026. 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 Spain. 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?

This study is still under way. Results are not available in the source record yet.

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?

Rate of invasive CRC (time frame: 10 years). The study lists 6 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 NCT04967183, which also lists 16 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 3 Sep 2026.

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