EPoS (European Polyp Surveillance)
The EPoS-project is addressing one of the most important challenges in the prevention of colorectal cancer; the surveillance of patients that have had colorectal polyps removed (polypectomy). The study is conducted by leading researchers within gastroenterology, epidemiology and biostatistics from Europe and the United States.
About the project
In the EPoS-study we plan to investigate various time intervals for surveillance of patients with colorectal polyps. There will be three studies randomizing more than 30,000 patients in Spain, Norway, the Netherlands, Italy, Sweden, the UK and Poland to different surveillance colonoscopy intervals after polypectomy. This is done to disentangle the most effective and cost-effective surveillance strategy for the population, and it is the largest study ever conducted within this field.
The primary trial endpoint will be incidence of colorectal cancer. The incidence will be compared in the different surveillance arms, to investigate the optimal time intervals for surveillance of patients with colorectal polyps.
There are a lot of large scale colorectal cancer screening programmes being carried out in most Western countries. These programmes are diagnosing large numbers of individuals with colorectal polyps. This creates both a diagnostic and resource dilemma, because the optimal surveillance strategy of these individuals to reduce their future cancer risk is currently unknown. Still, there are surveillance recommendations after polyp removal both in Europe and the United States, but these are based on low quality evidence. Therefore there is a need for large-scale prospective clinical trials.
The study is carried out by the Clinical Effectiveness research group and several outstanding research institutions in Europe and the United States:
- Harvard T.H Chan School of Public Health, Boston
- Karolinska Instituttet, Stockholm
- Erasmus Medical Centre, Rotterdam,
- Marie Curie Sklodowska, Warsawa
- Sloan Kettering Memorial, New York City
- Uppsala Universitetssykehus, Uppsala
- Universitetssykehuset i Alicante, Spania
- Universitetssykehuset i Hamburg-Eppendorf
- Universitetet i Edinburgh,The Roslin Institute
- Deutsches Krebsforschungszentrum, Division of Preventive Oncology , Germany,
- Epidemiologia dei Tumori II. AOU S Giovanni Battista - CPO Piemonte. Torino, Italy.
The inclusion period is three years, 2015 - 2017 with the last colonoscopy ten years after the last included participant.
The first six patients were randomized in May 2015 at the center in Kristiansand. Oslo University Hospital, Rikshospitalet and Ullevål randomized their first shortly after. Spain also ranomized their first patient i August 2015.