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Point of Care Test to Diagnosed Colorectal Cancer and Polyps in Low Middle Income Countries

Completed
Conditions
Colorectal Cancer
Interventions
Diagnostic Test: Biosensor Point of Care Device
Registration Number
NCT03173729
Lead Sponsor
Obafemi Awolowo University Teaching Hospital
Brief Summary

This is a-two phase study. Phase 1 will adapt a 3-metabolite biosensor that identifies patients with colorectal cancer (CRC) and precancerous polyps to Nigerian patients. Phase 2 will pilot test and evaluate the point-of-care (POC) biosensor device in Nigeria.

Detailed Description

In Phase 1, urine will be collected from 450 Nigerian patients (150 with CRC, 150 with polyps, and 150 patients with no colon premalignant or malignant pathology. These samples will be used to refine a handheld biosensor. This handheld biosensor is intended to be a cost-effective POC diagnostic test highly sensitive for CRC in Nigerian patients.

In Phase 2, the biosensor device will be piloted in Nigeria with 75 patients that are high-risk for CRC.. After the pilot, POC test in real-time analysis on urine from 645 patients who are in one of three groups: 1.\> 40 years of age with rectal bleeding; 2.a family history of CRC; 3. have a diagnosis of CRC. All patients will receive a colonoscopy. Beliefs and barriers related to urine testing for CRC will be investigated. Study will be completed within 5 years.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
926
Inclusion Criteria
  • Patients > 40 years of age with LGI bleeding OR

  • Patients who are high risk due to family history of CRC

    o Must be at most 10 years younger than when relative presented with CRC (for example, a patient with a relative diagnosed at age 40 with CRC will be eligible after age 30) OR

  • Patients with a diagnosis of stage I-III CRC who have no evidence of disease

Exclusion Criteria
  • Patients who are unable to provide written informed consent;
  • Previous diagnosis, treatment, or surgery for any cancer other than CRC
  • Age younger than 40 years with no family history of CRC
  • Any significant medical comorbidities
  • Inability to provide a urine sample no fewer than 3 days before colonoscopy
  • Inability to fully complete the patient satisfaction survey tool
  • Diagnosis of or suspected inflammatory bowel disease.

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
Phase 2 Field TestBiosensor Point of Care Device75 patients who are high risk for CRC as described in the eligibility
Phase 2 Validation Study Cohort 2Biosensor Point of Care DeviceLGI bleeding (n = 240)
Phase 2 Validation Study Cohort 1Biosensor Point of Care DeviceFamily history of CRC (n = 330)
Phase 2 Validation Study Cohort 3Biosensor Point of Care DevicePatients with history of CRC (n = 75)
Primary Outcome Measures
NameTimeMethod
Sensitivity and specificity of a point of care device to diagnose colorectal cancer and polyps5 years

We have designed a urine-based point of care diagnostic test to risk-stratify patients at high-risk for colorectal cancer. that will have 50% specificity and 80% sensitivity among Nigerian targeted population.

Secondary Outcome Measures
NameTimeMethod
Cost per patient of point of care urine test for diagnosing patients with colorectal cancer and polyps.3 years

The cost per patient will be determined using a cost effectiveness model already developed for the urine screening test in high-income countries.

Number of patients that are willing to consider continued colorectal cancer surveillance with a urine point of care test.3 years

The barriers and attitudes of patients towards a point of care urine test will be used to predict how many patients are willing to use this methodology.

Trial Locations

Locations (5)

Endoscopy Unit, University of Ilorin Teaching Hospital

🇳🇬

Ilorin, Kwara State, Nigeria

Federal Medical Center

🇳🇬

Owo, Ondo State, Nigeria

Endoscopy Unit, University College Hospital

🇳🇬

Ibadan, Osun State, Nigeria

Ladoke Akintola University Teaching Hospital

🇳🇬

Osogbo, Osun State, Nigeria

Endoscopy Unit, Obafemi Awolowo University Teaching Hospitals

🇳🇬

Ile Ife, Osun, Nigeria

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