Surveillance Colonoscopy in Older Adults: The SurvOlderAdults Study
This study, called SurvOlderAdults, is looking at colorectal cancer risk in older adults (age 75 and above). Researchers want to understand if having a repeat colonoscopy after age 75 helps reduce cancer risk for those who previously had precancerous polyps removed. They will compare cancer risk in older adults who had polyps removed to those who had a normal colonoscopy. The study will also gather opinions from older adult patients and healthcare providers about the benefits and risks of repeat colonoscopies. This is an observational study, meaning researchers will look at existing health information. The main goal is to see how often colorectal cancer occurs over many years. You may be eligible if you are a Veteran aged 75 or older who had a colonoscopy between 2005-2019, before turning 75.
- Study design
- This is an observational study with a planned enrollment of 130,000 participants. It will compare colorectal cancer risk in different groups of older adults.
- What's involved
- Not specified in the trial record.
- Compensation
- Not stated in the trial record.
- Follow-up
- Participants will be followed for colorectal cancer incidence for up to 20 years.
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NCT05994482
Surveillance Colonoscopy in Older Adults: The SurvOlderAdults Study
Recruiting
Not specifiedAges 75+ObservationalVA Office of Research and DevelopmentGovernment-funded
~130,000 participants
Updated 2026-05-12 on ClinicalTrials.gov
What's tested:adenoma vs no adenomacolonoscopy vs no colonoscopysurvey and expert panel
At a glance
Recruiting sites
2 of 2 listed sites are recruiting right now
RecruitingSuspended, closed, or not yet open
What they're measuring
colorectal cancer incidence
Measured over at anytime during follow up, ranging up to 20 years.
Conditions
Where it's being run
2 sites across 1 statesCalifornia2
Study leadership
- Samir Gupta, MD MS · PRINCIPAL_INVESTIGATOR · VA San Diego Healthcare System, San Diego, CA
- Folasade Popoola May, MD MSPH PhD · PRINCIPAL_INVESTIGATOR · VA Greater Los Angeles Healthcare System, West Los Angeles, CA
Who to contact
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Do you actually qualify for this trial?
Add a private profile and we'll compare every criterion below against your situation — and tell you which ones are met, uncertain, or excluding.
Eligibility criteria
Inclusion
The study base will consist of any Veteran alive at age 75 between 2005-2019, with exposure to a qualifying colonoscopy in the 10-year period prior to turning age 75
The investigators will include those with a qualifying colonoscopy associated with a colonoscopy note that can be processed by the previously established natural language processing (NLP) pipelines for extracting colonoscopy data from free-text reports60, 61 (see prior work below)
The colonoscopy done closest to, but prior to age 75 will be considered as a candidate qualifying colonoscopy
Date of qualifying colonoscopy prior to age 75 will be defined as the qualifying colonoscopy reference date
The study base for Aim 2 consists of Veterans ages 75 and alive between 2003-2019 who had a polypectomy prior to turning age 75
Identification of the study base for Aim 2 will take a distinct approach from Aim 1
A candidate qualifying colonoscopy event will be defined by presence of a CPT code for colonoscopy associated with a pathology note-based diagnosis of an adenoma within 30 days of the CPT code for colonoscopy
The colonoscopy event occurring closest to, but prior to age 75 will be selected
From the study base, all individuals who developed incident or fatal CRC, and a random sample of the entire study base will undergo manual EHR chart review to confirm study eligibility
To identify candidate incident CRC cases, the investigators will identify all adults with a CRC diagnosis at ages 75, utilizing the Oncology Domain with the same strategy for incident CRC identification as described for Aim 1
To identify candidate fatal CRC cases, the investigators will identify all adults with a fatal CRC diagnosis at ages 75, using NDI cause-specific mortality data
To identify candidate members of the subcohort for chart review, a random sample of the study base will be drawn
This sample may include Veterans with and without subsequent CRC. Rationale for including Veterans with and without subsequent CRC (incident and/or fatal) in the control subcohort is well established
Specifically, if the investigators were to conduct a cohort study without sampling, then at the start of follow up, the cohort would include people with subsequent CRC
In a traditional cohort study, every CRC case contributes to the denominator of individuals at risk. Thus, by including in the subcohort Veterans with and without CRC on follow up, the investigators are able to calculate risk based on exposure to surveillance as if the investigators had conducted a cohort study utilizing the entire cohort
The investigators will use EHR data to generate a list of VASDHS and VAGLA patients who have:
a) age 75
b) history of colonoscopy with polypectomy in the past 10 years
c) been referred for surveillance colonoscopy
The investigators will randomly select patients, recruiting until the investigators have 12 who completed surveillance colonoscopy and 12 who have not completed surveillance
The investigators will monitor the sample to assure sex balance consistent with VA demographics for patients who have had colonoscopy (98.2% male and 1.8% females age 75)
The investigators will also ensure that at least one- third of sampled patients have moderate or severe frailty based on the claims-based VA-FI36, 64 and make efforts to maintain patient racial/ethnic and geographic (i.e. San Diego/Los Angeles areas) diversity
The investigators will conduct interviews with 20 providers, specifically 10 primary care providers (including 3-4 geriatricians) and 10 gastroenterologists
The investigators will select providers from a randomly generated list of practicing VA clinicians (5/8th or greater) at VASDHS or VAGLA
If the investigators experience challenges reaching the target sample size, the investigators will employ snowball sampling by asking participants to name other potentially eligible clinicians
The investigators anticipate reaching thematic saturation given \> 17 interviews in each group and have made provisions to accommodate up to 6 additional patient and/or provider interviews if new themes continue to arise by the end of the planned interviews
The investigators will make efforts to achieve geographic balance to ensure provider representation from VASDHS and VAGLA
The investigators will convene a group of 15-20 multi-level stakeholders for the in-person expert panel in Quarter 1 of Year 4
The panel will include VA patients and caregivers (not included in Aim 3a):
VA providers
VA leadership and policymakers
health services and clinical researchers
individuals with non-VA healthcare systems perspectives
Exclusion
History of CRC prior to age 75
History of sessile serrated adenoma/polyp/lesion (SSL), traditional serrated adenoma (TSA), or large serrated polyp (LSP, defined as hyperplastic polyp \>10mm) at qualifying colonoscopy
History of inflammatory bowel disease (IBD) prior to age 75
Absence of exposure to normal colonoscopy or colonoscopy with polypectomy between ages 65-75
absence of a reviewable colonoscopy note
absence of polypectomy with adenoma diagnosis at candidate qualifying colonoscopy event
presence of a SSL, TSA, or LSP
history of CRC or IBD
history of hereditary cancer syndrome (this criteria is not used for Aim 1 because it cannot be reliably assessed with structured EHR data)
What this trial measures
- colorectal cancer incidenceat anytime during follow up, ranging up to 20 years.
colorectal cancer