Grant: Project Grant

Colorectal cancer (CRC) is the 2nd leading cause of cancer death in Canada. Removal of colorectal adenomas (polyps) is an important way to reduce someones risk of CRC. A person who has had one or more adenomas removed is at increased risk for future adenomas and cancer. Therefore, it is currently recommended that these people undergo regular colonoscopies. However, it is a limited resource that plays an important role in the diagnosis and treatment of many colon diseases. It is also an invasive procedure that can result in serious complications. It is possible that the highly sensitive fecal immunochemical test (FIT) could replace colonoscopy for the detection of new adenomas. FIT is a simple, cheap and non-invasive stool test. The goal of this study is to determine whether FIT can be used as the primary post-colonoscopy surveillance tool among average-risk individuals in Alberta. We will recruit 1,500 individuals referred to Alberta Health Services' Colon Cancer Screening Centre for a colonoscopy to look for new polyps. Participants will complete a baseline health questionnaire and a FIT prior to undergoing a complete colonoscopy with removal of all identified polyps. The prevalence of advanced lesions (advanced polyps or cancer) and how well FIT performs will be determined. We will also use statistical procedures to develop a rule using patient demographic and clinical characteristics to identify a prediction model aimed at predicting new adenomas. Our study will provide essential data to informing practice guidelines used by screening programs and care providers in Canada and other jurisdictions to provide effective screening and surveillance for CRC while ensuring timely access for other patient groups.