RATIONALE: Screening tests, such as colonoscopy and fecal occult blood test, may help doctors find tumor cells early and plan better treatment for colorectal cancer. PURPOSE: This randomized phase III trial is studying colonoscopy to see how well it works compared to fecal occult blood test in screening healthy participants for colorectal cancer.
OBJECTIVES: * Compare the neoplastic outcome of participants at average risk for colorectal cancer who undergo colonoscopy vs annual fecal occult blood tests. * Compare the endoscopic and clinical resources required for these screening methods in these participants. * Compare the benefit-to-harm ratio in participants undergoing these screening methods. * Determine the level of participation of participants undergoing these screening methods. OUTLINE: This is a randomized, two-part, multicenter study. Participants are asked whether they are interested in participating in a randomized controlled trial of colorectal cancer screening. * Screening colonoscopy feasibility study I (accrual completed as of 12/14/2004): Participants who are interested in participating in a screening trial are randomized to 1 of 2 screening arms. * Arm I: Participants undergo baseline screening colonoscopy. * Arm II: Participants receive standard care. * Screening colonoscopy feasibility study II: Participants who are interested in participating in a screening trial are randomized to 1 of 2 screening arms. * Arm I: Participants undergo baseline screening colonoscopy. Participants are given individualized recommendations for further surveillance based on the results of the colonoscopy. * Arm II: Participants undergo a baseline fecal occult blood test (FOBT). Participants are given individualized recommendations for further surveillance based on the results of the FOBT. Participants with negative baseline FOBT undergo FOBT annually for up to 4 years in the absence of a positive FOBT. All participants are followed annually for up to 4 years. PROJECTED ACCRUAL: A total of 1,402 participants (701 per screening arm) have been accrued for feasibility study I within 3 years (accrual completed as of 12/14/2004). An additional 3,550 participants (1,775 per screening arm) will be accrued for feasibility study II within 5 years.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SCREENING
Masking
NONE
Enrollment
4,952
Participants with negative baseline FOBT undergo FOBT annually for up to 4 years in the absence of a positive FOBT
Participants undergo a baseline fecal occult blood test (FOBT)
Patients undergo baseline screening colonoscopy
Feist-Weiller Cancer Center at Louisiana State University Health Sciences
Shreveport, Louisiana, United States
Masonic Cancer Center at University of Minnesota (Data collection only)
Minneapolis, Minnesota, United States
Memorial Sloan-Kettering Cancer Center
New York, New York, United States
Kaiser Permanente Washington Health Research Institute (Data collection only)
Seattle, Washington, United States
Neoplastic findings as assessed by screening colonoscopy vs annual fecal occult blood test (FOBT)-directed colonoscopy
Time frame: 5 years
Burden on endoscopic and clinical resources
Time frame: 5 years
Harms associated with screening colonoscopy vs annual FOBT-directed colonoscopy
Time frame: 5 years
Benefit-to-harm ration for screening colonoscopy vs annual FOBT-directed colonoscopy
Time frame: 5 years
Level of participation in screening with FOBT-directed colonoscopy vs a single colonoscopy
Time frame: 5 years
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
Standard care