Plain English Summary
Background and study aims
A colonoscopy is an important procedure in which a narrow, flexible, telescopic camera is inserted into the back passage to look at the lining of the large bowel. Although it can be an uncomfortable procedure, it is the most effective way to diagnose colorectal cancer (bowel cancer). Although colonoscopies are very effective at finding tumours (neoplasms), it is reported that they do not always spot polyps. A polyp is a very small growth on the inner lining of the colon or rectum. Although most colorectal polyps do not become cancerous, almost all cases of colorectal cancer begin as polyps. It is therefore very important to detect polyps, as their presence increases the risk of colorectal cancer. A possible reason that polyps are sometimes missed in colonoscopies may be because of inadequate equipment. A full spectrum endoscope (FUSE) is a device that has been developed to help lower the miss rate of polyps in routine colonoscopies. The device uses three cameras to give a panoramic view of the colon, allowing for a more complete picture of the colon. The aim of this study is to find out how well this new technology performs in comparison to the standard device used.
Who can participate?
Adults between 50 and 69 years of age, having their first colonoscopy after testing positively for blood in their stool in a mass screening programme.
What does the study involve?
Participants are randomly allocated in one of two groups. For participants in the first group, the colonoscopy procedure is completed using a standard forward-viewing colonoscopy. For participants in the second group, the procedure is completed using full spectrum endoscopy (FUSE). After the procedures, the accuracy of the two devices is compared. Participants also are asked to complete a questionnaire after the procedure about their experiences.
What are the possible benefits and risks of participating?
A potential benefit for participants in the FUSE group is that the procedure may reveal polyps that otherwise might have been missed. There are no risks of participating other than the standard risks involved with having a colonoscopy. Additionally, some additional polyps detected with the new instrument might not be clinically significant.
Where is the study run from?
Seven hospitals in Italy.
When is the study starting and how long is it expected to run for?
September 2014 to October 2015
Who is funding the study?
Regional Health Authority, Piedmont Region (Italy)
Who is the main contact?
Dr Carlo Senore
carlo.senore@cpo.it
Trial website
Contact information
Type
Scientific
Primary contact
Dr Carlo Senore
ORCID ID
Contact details
Via S Francesco da Paola 31
Turin
10123
Italy
+39 011 6333890
carlo.senore@cpo.it
Additional identifiers
EudraCT number
ClinicalTrials.gov number
Protocol/serial number
351
Study information
Scientific title
Assessing the additional neoplasia yield of FUll Spectrum Endoscopy in a CRC screening setting
Acronym
FUSE
Study hypothesis
The use of an instrument ensuring a wider view of the colonic mucosa would result in a higher rate of detection of significant colonic lesions as compared to standard instruments.
Ethics approval
Comitato etico interaziendale AOU Città della Salute e della Scienza, 26/05/2014, ref: N 531
Study design
Multi-centre stratified randomised parallel trial
Primary study design
Interventional
Secondary study design
Randomised parallel trial
Trial setting
Community
Trial type
Screening
Patient information sheet
Condition
1. Colorectal cancer
2. Colorectal adenomas
Intervention
Patients are randomly allocated into two groups, who will each undergo a colonoscopy. For patients in the first group, a standard white light HD endoscope (Standard Forward View) is used, and for patients in the second group, Full Spectrum Endoscopy (FUSE) technology is used. The two instruments are similar, the only difference being related to the characteristics and number of the lenses. The only difference for the patients might be related to the slightly longer duration of the exam with FUSE technology as it may be more likely to find one or more polyps. IN general a colonscopy is expected to last about 30 minutes. No study related follow-up after the completion of the colonoscopic assessment is planned within this study
Intervention type
Device
Phase
Drug names
Primary outcome measures
1. Additional yield of advanced adenomas in patients when using Fuse as compared to SFV
2. Proportion of patients detected with 3 or more adenomas when using Fuse as compared to SFV
Secondary outcome measures
1. Overall adenoma and polyp detection rate, flat adenoma and serrated polyps/adenomas detection rate of the two techniques, determined from the information recorded in endoscopist and pathology reports
2. Comparison of the size of multiple lesions detected by the two methods, determined from the information recorded in endoscopist and pathology reports
3. Comparison of the detection rate of neoplasia by colonic site: distal (rectum, sigmoid and descending colon) and proximal (proximal to the descending colon), determined from the information recorded in endoscopist and pathology reports
4. Differences in the surveillance guidelines post-colonoscopy when comparing the two arms, determined from the information recorded in endoscopist and pathology reports
5. Comparison of the time required to reach the cecum, determined from the information recorded in endoscopist and pathology reports
6. Comparison of the withdrawal and total procedure time, determined from the information recorded in endoscopist and pathology reports
7. Assessing the learning curve of participating endoscopists, determined from the information recorded in endoscopist and pathology reports
8. Assessing patient’s experience, measured using a questionnaire administered at the end of the examination
9. Assessing the specific contribution of the additional view estimating the proportion of polyps detected using the additional views only, determined from the information recorded in endoscopist and pathology reports
Overall trial start date
01/03/2014
Overall trial end date
31/12/2015
Reason abandoned
Eligibility
Participant inclusion criteria
Consecutive patients aged 50 to 69 years undergoing their first colonoscopy examination in the participating centers following a positive fecal immunochemical test (FIT) performed in the context of a regional mass-screening program.
Participant type
Other
Age group
Adult
Gender
Both
Target number of participants
Patients aged 50 to 69 undergoing their first colonoscopy examination in the participating centers following a positive fecal immunochemical test (FIT) performed in the context of a regional mass-screening program. The target sample size is 350 patients per arm
Participant exclusion criteria
1. Personal history of colorectal cancer or advanced adenoma
2. More than one first degree relative with colorectal cancer
3. Inflammatory bowel disease (IBD)
4. Endoscopy within past 5 years
Recruitment start date
01/09/2014
Recruitment end date
15/10/2015
Locations
Countries of recruitment
Italy
Trial participating centre
CPO Piemonte and Gastroenterology Unit 2 - AOU Città della Salute e della Scienza
Via S Francesco da Paola 31
Turin
10123
Italy
Trial participating centre
Ospedale Valduce
Como
22100
Italy
Trial participating centre
Istituto Clinico Humanitas
Rozzano (Milano)
20089
Italy
Trial participating centre
Ospedale di Circolo
Rho (Milano)
20017
Italy
Trial participating centre
Ospedale S Chiara
Trento
38122
Italy
Trial participating centre
IRCCS Ospedale S. Maria Nuova
Reggio Emilia
42100
Italy
Trial participating centre
Osepdale Nuovo Regina Margherita
Roma
00100
Italy
Funders
Funder type
Government
Funder name
Regional Health Authority, Piedmont Region (Italy)
Alternative name(s)
Funding Body Type
Funding Body Subtype
Location
Results and Publications
Publication and dissemination plan
A report to be submitted to a scientific journal, and preliminary results will be presented in the context of the next UEGW in Barcelona in October 2015.
Intention to publish date
31/10/2015
Participant level data
Stored in repository
Results - basic reporting
Publication summary