Screening for Colorectal Cancer in Older Patients (PLCO Screening Trial)

Colon Carcinoma Clinical Trial

Official title:

Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial

Clinical Trial Details — Status: Active, not recruiting

Administrative data

• NCT number: NCT01696981
• Other study ID #: NCI-2012-01757
• Secondary ID: NCI-2012-01757CD
• Status: Active, not recruiting
• Phase: N/A
• Start date: November 16, 1993
• Est. completion date: March 11, 2025

Study information

• Verified date: January 2024
• Source: National Cancer Institute (NCI)
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

This clinical trial studies whether screening methods used to diagnose cancer of the prostate, lung, colon, rectum, or ovaries can reduce deaths from these cancers. Screening tests may help doctors find cancer cells early and plan better treatment for colorectal cancer.

Description:

PRIMARY OBJECTIVES:

I. To determine whether screening with flexible sigmoidoscopy (60-cm sigmoidoscope) can reduce mortality from colorectal cancer in women and men aged 55-74 at study entry.

SECONDARY OBJECTIVES:

I. To assess screening variables, other than mortality, for each of the interventions including sensitivity, specificity, and positive predictive value.

II. To assess the incidence, stage, and survival of cancer cases. III. To investigate the mortality predictive value of biologic and/or prognostic characterizations of tumor tissue as intermediate endpoints.

IV. To conduct biomolecular and genetic research into factors associated with cancer carcinogenesis and promotion, as well as the early detection of these factors.

OUTLINE: Participants in the overall PLCO study are stratified by screening center, gender, and age (55-59 vs 60-64 vs 65-69 vs 70-74). Participants are randomized to 1 of 2 arms (control vs screening).

ARM I (Control): Participants receive standard medical care. Participants complete a Diet History Questionnaire (DHQ) at baseline.

ARM II (Colorectal Screening): Participants undergo a colorectal examination with a flexible sigmoidoscope at baseline and year 5. A scheduling and tracking procedure is implemented to ensure regular attendance at repeat screens for participants screened negative or for those who are designated suspicious or positive at screening but for whom subsequent diagnostic procedures do not reveal colorectal cancer (follow-up diagnostic procedures are through their own medical care environment). Participants diagnosed with colorectal cancer via a screening test are referred for treatment in accordance with current accepted practice for appropriate stage of disease, patient age, and medical condition; a procedure is provided for contact with qualified medical personnel to insure appropriate therapy.

Participants complete a Dietary Questionnaire (DQX) at baseline and DHQ at year 3. An Annual Study Update (ADU) (previously referred to as the Periodic Survey of Health [PSH] questionnaire) is mailed to each participant annually for 13 years to identify all prevalent and incident colorectal cancers as all deaths that occur among both screened and control subjects during the trial.

After completion of screening, participants are followed up for at least 13 years.

Recruitment information / eligibility

• Status: Active, not recruiting
• Enrollment: 154900
• Est. completion date: March 11, 2025
• Est. primary completion date: May 21, 2012
• Accepts healthy volunteers: No
• Gender: All
• Age group: 55 Years to 74 Years

Eligibility

Exclusion Criteria:

• Men and women who at the time of randomization are less than 55 or greater than or equal to 75 years of age

• Individuals undergoing treatment for cancer at this time, excluding basal-cell and squamous-cell skin cancer

• Individuals with known prior cancer of the colon, rectum, lung, prostate

• This includes primary or metastatic PLCO cancers

• Individuals with previous surgical removal of the entire colon, one lung, or the entire prostate (men only)

• Until October 1996, women with previous surgical removal of both ovaries were excluded from the trial. In order to increase the enrollment of women into the trial, beginning in October 1996, these women were no longer excluded for this reason.

• Individuals who are participating in another cancer screening or cancer primary prevention trial

• Males who have taken Proscar/Propecia/finasteride in the past 6 months

• NOTE: Individuals who are already enrolled in the trial when their physician prescribes finasteride are not prevented from taking this medication. As a result, these participants will continue to be screened and followed just as those participants who are not on finasteride.

• NOTE: Men who are taking Tamoxifen are not excluded from any part of the PLCO Screening Trial.

• Prior to April 1, 1999 women were excluded from the trial if they were currently taking or had taken Tamoxifen or Evista\Raloxifene in the past 6 months. As of April 1999 based on a decision from the PLCO Ovary Subcommittee, women who have or are currently taking Tamoxifen or Evista\Raloxifene are not excluded from participation.

• Individuals who are unwilling or unable to sign the informed consent form

• Males who have had more than one PSA blood test in the past three years

• Individuals who have had a colonoscopy, sigmoidoscopy, or barium enema in the past three years

Related Conditions & MeSH terms

• Carcinoma
• Colon Carcinoma
• Rectal Carcinoma

Intervention

Other:
• Screening Questionnaire Administration
Undergo questionnaire assessments

Procedure:
• Sigmoidoscopy
Undergo a flexible sigmoidoscopy

Locations

Country	Name	City	State
United States	National Institutes of Health Clinical Center	Bethesda	Maryland

Sponsors (1)

Lead Sponsor	Collaborator
National Cancer Institute (NCI)

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Colorectal Cancer Deaths	Colorectal cancer deaths confirmed in participants by a death review committee if available, otherwise by death certificate.	Events through 13 years of follow-up or through December 31, 2009; median follow-up 12.1 years.
Primary	Colorectal Cancer Death Rates	Colorectal cancer deaths confirmed in participants by a death review committee if available, otherwise by death certificate. Rate is the number of deaths divided by person years of follow-up in the study.	Events through 13 years of follow-up or through December 31, 2009; median follow-up 12.1 years.
Secondary	Deaths From All Causes	Deaths from all causes were compared between the colorectal cancer screening arm and the usual care arm.	Events through 13 years of follow-up or through December 31, 2009; median follow-up 12.1 years.
Secondary	Death Rates From All Causes	Deaths from all causes were compared between the colorectal cancer screening arm and the usual care arm. Rate is the number of deaths divided by person years of follow-up in the study.	Events through 13 years of follow-up or through December 31, 2009; median follow-up 12.1 years.
Secondary	Colorectal Cancer Incidence	Colorectal cancer diagnoses confirmed by medical record abstraction.	Events through 13 years of follow-up or through December 31, 2009; median follow-up 12.1 years.
Secondary	Colorectal Cancer Incidence Rates	Colorectal cancer diagnoses confirmed by medical record abstraction. Incidence rate (cumulative) defined as colorectal cancer diagnoses divided by person years at risk for colorectal cancer.	Events through 13 years of follow-up or through December 31, 2009; median follow-up 12.1 years.
Secondary	Complications of Diagnostic Evaluation Following a Positive Screening Test	Number of participants who experienced complications during diagnostic work-up of a positive colorectal examination.	One year from screening examination
Secondary	T0 (Baseline) FSG Screening Results	Flexible sigmoidoscopy (FSG) result	T0 (at study entry)
Secondary	T3/T5 FSG Screening Result	Flexible sigmoidoscopy (FSG) result	T3 (three years after entry) or T5 (five years after entry)