Colonoscopy Versus Stool-based Testing for Older Adults With a History of Colon Polyps

What this Trial Is About

Researchers are evaluating two methods for monitoring older adults aged 65 to 82 who have a history of colorectal polyps and are due for surveillance colonoscopy. The study compares annual fecal immunochemical testing (FIT), a noninvasive stool-based test, with standard colonoscopy to determine which is more effective in detecting advanced neoplasia. This research aims to address concerns about the risks and inconvenience of repeated colonoscopies in older adults, especially those with low-risk polyps and other health issues that may limit their benefit from frequent colonoscopy. Participants are randomly assigned to one of two groups: one group receives annual FIT tests at home, while the other undergoes a one-time surveillance colonoscopy. The study will follow participants for up to 11 years to compare outcomes. The FIT group will complete stool tests each year, and the colonoscopy group will have their procedure once during the study period. Both methods are diagnostic tests used to monitor colorectal health. Throughout the study, participants will be evaluated with surveys assessing their satisfaction, trust, cancer worry, perceived cancer risk, emotional benefits of surveillance, and overall health. Safety monitoring includes tracking any major or minor harms within 30 days after colonoscopy. Researchers will measure the incidence of advanced neoplasia in both groups as the primary outcome. The study involves regular follow-up assessments over several years, with data collection continuing for up to 11 years.

Colonoscopy vs Stool Testing for Older Adults With Colon Polyps