Colonoscopy vs Stool Testing for Older Adults Colon Polyps

This is a multi-site comparative effectiveness randomized controlled trial (RCT) comparing annual fecal immunochemical testing (FIT) and colonoscopy for post-polypectomy surveillance among adults aged 70-82 with a history of colorectal polyps who are due for surveillance colonoscopy.

Inclusion Criteria:English or Spanish speakingPersonal history of colorectal polypsMost recent colonoscopy with ≤2 non-advanced polypsCurrently due or coming due within 12 months for colonoscopyAble to provide written informed consentExclusion Criteria:Personal history of colorectal cancerPersonal history of genetic syndrome with high risk for colorectal cancer (e.g. Lynch Syndrome, Familial Adenomatous Polyposis Syndrome (FAP), or Serrated Polyposis Syndrome)Personal history of inflammatory bowel disease (e.g. ulcerative colitis, Crohn's disease)Most recent colonoscopy with advanced polyp(s) or ≥3 non-advanced polypsPatients unlikely to benefit from polyp surveillance (e.g., history of heart disease or coronary artery disease with treatment in the last 6 months, heart failure affecting function, lung disease requiring use of home oxygen, stroke within the last 4 months, dementia affecting ADLs or IADLs, severe liver disease requiring the use of certain medications to control fluid, confusion, or bleeding, severe kidney disease requiring dialysis, or a new cancer diagnosis within the last year)Patients with an existing, scheduled appointment for surveillance colonoscopyPatients unable to provide written informed consentPatients who lack a valid mailing address