The Utility and Feasibility of Mt-sDNA as a Surveillance Procedure in Colorectal Cancer Survivors

Study Overview
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Brief Summary
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The purpose of this research study is to determine whether testing of stool for a panel of markers will enable us to detect polyps and cancer compared to standard testing.

Detailed Description
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Participants who were diagnosed with Stage I-III colorectal cancer will undergo testing with mt-sDNA followed by a questionnaire about satisfaction with mt-sDNA (multitarget stool DNA panel), prior to their scheduled colonoscopies at years 1 and 4 after diagnosis. Participants will be asked to provide a stool sample for mt-sDNA (Cologuard) testing that will be collected within 90 days before their scheduled colonoscopy. The kit will be given to the participant by study personnel and mailed back directly to Exact Science.

Official Title
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The Utility and Feasibility of Mt-sDNA as a Surveillance Procedure in Colorectal Cancer Survivors

Conditions
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Adenocarcinoma of the Colon, Adenocarcinoma of the Rectum, Stage I Colorectal Cancer, Stage II Colorectal Cancer, Stage III Colorectal Cancer

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Diagnosis of stage I, II or III adenocarcinoma of the colon or rectum Receipt of preoperative colonoscopy Receipt of bowel resection; use of adjuvant chemotherapy or radiation therapy as clinically indicated Exclusion Criteria: Stage IV colorectal cancer Surgical treatment with subtotal colectomy or total proctocolectomy Diagnosis of inflammatory bowel disease (ulcerative colitis or Crohn's disease) Diagnosis of polyposis syndrome including Lynch syndrome or familial polyposis Presence of advanced adenomas (1 cm or larger, villous features and/or high grade dysplasia) that were not removed at the preoperative colonoscopy or contained in the resection specimen. Inability to provide informed consent Inability to understand spoken and written English Medical comorbidities that would be contraindications to sedation or that would preclude any benefit of routine surveillance post-resection. These would be at the discretion of the participant's providers.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Sensitivity of mt-sDNA compared to Colonoscopy | Compare the results between mt-sDNA (categorized as a single positive or negative result) with the findings at colonoscopy, the gold standard. Colonoscopy will be considered positive if an adenoma or carcinoma is found and otherwise negative. Sensitivity is defined as True Positive (TP)/(TP+ False Negative (FN)) | at 1 and 4 years | 
| Specificity of mt-sDNA compared to Colonoscopy | Compare the results between mt-sDNA (categorized as a single positive or negative result) with the findings at colonoscopy, the gold standard. Colonoscopy will be considered positive if an adenoma or carcinoma is found and otherwise negative. Specificity is defined as True Negative (TN)/(TN+ False Positive (FP)) | at 1 and 4 years | 
| Participant acceptance of mt-sDNA as a follow up strategy compared to colonoscopy as measured by the Stool Test Satisfaction Survey. | Participant acceptance as measured by the Stool Test Satisfaction Survey, which includes 14 questions scored on a Likert scale. Possible scores ranging from 14 - 70, with higher scores indicating better outcomes. Responses will be grouped based on the distribution, but most likely as 1-2 (neutral, unfavorable or least favorable ) versus 3-5 (most favorable or very favorable). | at 1 and 4 years |