Surveillance Colonoscopy in Older Adults: The SurvOlderAdults Study

Part of paid clinical trials in San Diego, California.

Sponsor
VA Office of Research and Development
Study ID
NCT05994482
Status
Recruiting
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Conditions

Eligibility Criteria

Sex
ALL
Age
75 Years - N/A
Healthy Volunteers
Not accepted

Interventions

  • adenoma vs no adenoma — OTHER
    For Aim 1, the investigators will examine colorectal cancer risk among older adults with prior removal of a precancerous polyp (adenoma) vs a prior normal colonoscopy
  • colonoscopy vs no colonoscopy — OTHER
    For Aim 2, the investigators will examine colorectal cancer risk among older adults with prior history of polypectomy, exposed vs unexposed to subsequent surveillance colonoscopy
  • survey and expert panel — OTHER
    The investigators will conduct 44 semi-structured one-on-one qualitative interviews with VA patients (older adults) and providers (primary care, GI, geriatrics) to understand perspectives on CRC risk, and potential benefits and harms of surveillance (Aim 3a). The investigators will then convene an expert panel with key stakeholders including Veterans, primary providers, geriatricians, gastroenterologists, VA leaders, and policy makers to present Aim 1, 2, and 3a findings (Aim 3b). The primary outcome will be specific recommendations regarding use of surveillance colonoscopy in older adults, ranked by priority and feasibility, that can guide VA policy around future implementation (or de-implementation) of surveillance among older adults.

Study Details

Colorectal cancer is a leading cause of cancer death. Detection and removal of polyps can reduce risk for developing colorectal cancer. After finding and removing precancerous polyps, repeat colonoscopy is routinely recommended. However, it is unclear whether repeat additional colonoscopy further reduces risk for colorectal cancer. For older adults age 75 and older, the lack of this information is especially important, given that the risks of colonoscopy go up with age. This research will evaluate whether older adults with a prior history of precancerous polyps have higher colorectal cancer risks compared to older adults who had a prior normal colonoscopy, and whether, among those with prior precancerous polyps, repeating a colonoscopy after age 75 is associated with reduced cancer risk. The investigators will synthesize these data and gather perspectives from Veterans and clinical stakeholders to make recommendations on whether older adults with a prior history of polyps should continue or defer colonoscopy after age 75.

Key Dates

Start date
Oct 1, 2023
Status verified
May 2026
Primary completion
Sep 30, 2026
Completion
Sep 30, 2027

Study Design

Enrollment
130,000 participants (estimated)

Arms

  • Arm: Older adults
    Aim 1: Older adults with and without a prior history of precancerous polyps
  • Arm: Older adults with prior polypectomy
    Aim 2: Older adults with a prior history of precancerous polyps, exposed vs unexposed to surveillance colonoscopy
  • Arm: Stakeholders
    Aim 3: Veterans, clinical, and policy stakeholders who will provide input and participate in an expert panel to synthesis available evidence on pros/cons of surveillance in older adults.

Primary Outcome Measure

colorectal cancer incidence [ Time Frame: at anytime during follow up, ranging up to 20 years. ]

Central Contacts

Locations (2)

FacilityCityStateZIPSite coordinators
VA San Diego Healthcare System, San Diego, CASan DiegoCalifornia92161-0002
Samir Gupta, MD MS
[email protected]
858-552-8585
Samir Gupta, MD MS (PRINCIPAL_INVESTIGATOR)
VA Greater Los Angeles Healthcare System, West Los Angeles, CAWest Los AngelesCalifornia90073-1003
Folasade P May
[email protected]
310-478-3711

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By condition
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By specialty
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By research site
VA San Diego Healthcare System, San Diego, CA· San Diego, CAVA Greater Los Angeles Healthcare System, West Los Angeles, CA· West Los Angeles, CA

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