Comparing Fecal Blood Testing to Colonoscopy for Surveillance After Colorectal Polyp Removal

What this Trial Is About

Researchers are investigating whether fecal occult blood testing FIT is as effective as colonoscopy for monitoring patients after removal of colorectal polyps. Colorectal cancer, the third most common cancer worldwide, often develops from benign polyps. Colonoscopy with polyp removal lowers cancer risk, but many surveillance colonoscopies find no high-risk issues, leading to unnecessary procedures that are burdensome and resource-intensive. This trial aims to see if FIT can reduce the need for colonoscopy while maintaining patient safety and surveillance quality. Participants in this randomized trial will be assigned to one of two groups standard colonoscopy surveillance or fecal blood testing. Those in the FIT group will only undergo colonoscopy if their test detects blood. This approach may reduce colonoscopy use by over 50%, lower costs, and decrease patient discomfort, complications, and overdiagnosis. The study evaluates these methods over a long term, with primary outcomes assessed 12 years after randomization. During the study, participants will be monitored for colorectal cancer incidence and mortality, advanced neoplasia occurrence, colonoscopy findings, adherence to surveillance, cost-effectiveness, adverse events, and environmental impact. Follow-up includes evaluations at 3 and 12 years, with safety checks 30 days post-colonoscopy. The trial spans up to 12 years of participation, allowing comprehensive assessment of both surveillance strategies.

Randomized Trial Comparing Fecal Testing (FIT) to Colonoscopy for Post-polypectomy Surveillance