NCT03790475

Brief Summary

The PICCOLINO is a randomized health services study performed within the framework of the Polish Colonoscopy Screening Program (PCSP) in Poland. Within the study 12,298 eligible persons between 55 and 64 years of age will be drawn from the Population Registry and randomly assigned in a 1:1:1 ratio to receive an invitation to participate in one of the three screening strategies: (I) postal invitation to colonoscopy and a re-invitation to colonoscopy for initial non-responders, (II) postal invitation for screening using fecal immunochemical test (FIT) for non-responders and subjects refusing a colonoscopy, or (III) postal invitation offering a choice between FIT and colonoscopy. Colonoscopies will be performed in seven local centers participating in the study. FITs will be analyzed in the central laboratory. Subjects with positive FIT result will be recommended to undergo colonoscopy. The primary outcome is participation with CRC screening within 18 weeks after enrollment, defined as completion of colonoscopy, or completion of FIT along with colonoscopy for positive FIT result. Secondary outcome will be diagnostic yield for advanced neoplasia (CRC or advanced adenoma). The study has been approved by a local bioethics committee.

Trial Health

43
At Risk

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Trial has exceeded expected completion date
Enrollment
12,298

participants targeted

Target at P75+ for not_applicable colorectal-cancer

Timeline
Completed

Started Aug 2018

Geographic Reach
1 country

1 active site

Status
unknown

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Start

First participant enrolled

August 25, 2018

Completed
4 months until next milestone

First Submitted

Initial submission to the registry

December 21, 2018

Completed
10 days until next milestone

First Posted

Study publicly available on registry

December 31, 2018

Completed
1 year until next milestone

Primary Completion

Last participant's last visit for primary outcome

December 31, 2019

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

December 31, 2019

Completed
Last Updated

December 31, 2018

Status Verified

December 1, 2018

Enrollment Period

1.4 years

First QC Date

December 21, 2018

Last Update Submit

December 28, 2018

Conditions

Keywords

Colorectal Cancer Screening

Outcome Measures

Primary Outcomes (1)

  • Completion of the assigned screening strategy within 18 weeks of enrollment

    Completion of the assigned screening strategy within 18 weeks of enrollment defined as: * current screening strategy: documented screening colonoscopy, * sequential and multiple options strategies: documented colonoscopy, or receipt of FIT containing stool specimen. A positive FIT result requires subsequent documented colonoscopy to qualify as completed.

    Within 18 weeks of enrollment

Secondary Outcomes (1)

  • Diagnostic yield for CRC and advanced adenomas

    Within 18 weeks of enrollment

Study Arms (3)

Current screening practice.

NO INTERVENTION

Subjects randomized into this group will receive named invitations for colonoscopy with pre-specified date, contact details of dedicated screening center. Invitations will be sent 6 weeks prior to suggested date of screening test. All subjects not responding to the invitation will receive a reminder letter 3 weeks prior to proposed appointment date. Additionally, a re-invitation for colonoscopy (screening test in 6 weeks) will be sent to participants not responding to the first invitation and the reminding letter.

Sequential screening strategy.

EXPERIMENTAL

Subjects randomized into this group will be initially invited to participate in a screening colonoscopy as per group 1. All subjects who will refuse colonoscopy or do not respond to invitation within 6 weeks since the first letter, will receive another invitation letter with FIT test enclosed. The screening office will contact persons with a positive test result in order to determine the date of the colonoscopy appointment. A negative test result will be sent together with a recommendation to have another screening test performed 2 years later and information about the possible delivery of the test in two years.

Other: Offering an alternative colorectal cancer screening method

Multiple options screening strategy.

EXPERIMENTAL

Subjects in this group will receive a letter with an offer to choose between colonoscopy or FIT screening. The first letter will include an invitation with a scheduled date of colonoscopy (in 6 weeks) and a FIT kit. Three weeks before a scheduled date of colonoscopy subjects randomized into this group will receive a reminder letter with an information about proposed screening methods. After the scheduled date of the colonoscopy examination, subjects who will not respond to the invitation for colonoscopy and will not send the FIT test back to the laboratory will receive another invitation for colonoscopy (in 6 weeks) and a FIT kit.

Other: Offering a choice for colorectal cancer screening

Interventions

Persons randomized to the multiple options screening strategy group will receive a postal invitation offering a choice between FIT and colonoscopy.

Multiple options screening strategy.

Persons randomized to the sequential screening strategy group will receive a postal invitation to the colonoscopy followed by a postal invitation for screening using FIT for non-responders and subjects refusing colonoscopy.

Sequential screening strategy.

Eligibility Criteria

Age55 Years - 64 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64)

You may qualify if:

  • Men and women aged 55 to 64 years residing in Poland and assigned to be invited to screening within the Polish Colonoscopy Screening Program .

You may not qualify if:

  • information of a selected subject death informed by family, neighbors or post office that has not been included in the Personal Identity Number (PESEL) system.
  • addressees of letters that have been returned by the post office.
  • subjects requiring long-term care due to somatic, psychosocial reasons or with mental disability.
  • history of colorectal resection.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Maria Sklodowska-Curie Institute - Oncology Center

Warsaw, Poland

RECRUITING

Related Publications (1)

  • Pilonis ND, Bugajski M, Wieszczy P, Rupinski M, Pisera M, Pawlak E, Regula J, Kaminski MF. Participation in Competing Strategies for Colorectal Cancer Screening: A Randomized Health Services Study (PICCOLINO Study). Gastroenterology. 2021 Mar;160(4):1097-1105. doi: 10.1053/j.gastro.2020.11.049. Epub 2020 Dec 9.

MeSH Terms

Conditions

Colorectal Neoplasms

Condition Hierarchy (Ancestors)

Intestinal NeoplasmsGastrointestinal NeoplasmsDigestive System NeoplasmsNeoplasms by SiteNeoplasmsDigestive System DiseasesGastrointestinal DiseasesColonic DiseasesIntestinal DiseasesRectal Diseases

Central Study Contacts

Michal Filip Kaminski, MD, PhD

CONTACT

Nastazja Dagny Pilonis, MD

CONTACT

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
NONE
Purpose
HEALTH SERVICES RESEARCH
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
MD, PhD

Study Record Dates

First Submitted

December 21, 2018

First Posted

December 31, 2018

Study Start

August 25, 2018

Primary Completion

December 31, 2019

Study Completion

December 31, 2019

Last Updated

December 31, 2018

Record last verified: 2018-12

Locations