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ULTRA-high-risk Surveillance to Avoid Future Events: the ULTRA-SAFE Trial

Status: Recruiting
Location: See all (4) locations...
Intervention Type: Diagnostic test
Study Type: Interventional
Study Phase: Not Applicable
SUMMARY

The ULTRA-SAFE clinical trial is a prospective, randomized study designed to address the limitations of current one-size-fits-all colorectal cancer surveillance guidelines. While international standards recommend a three-year follow-up colonoscopy for all high-risk patients, data suggests that those with multiple advanced adenomas face a significantly higher recurrence risk (20%) compared to those with only low-risk adenomas (9%). To provide more personalized care, the trial compares a Standard Arm (colonoscopy at year three) against a FIT Arm, where participants undergo annual fecal immunochemical testing in years one and two. A positive FIT triggers an earlier colonoscopy, with the goal of reducing the 3-year prevalence of metachronous advanced colorectal neoplasms (meta-ACRN) from 20% to approximately 12.7%. The study has enrolled roughly 940 participants to statistically validate whether this early screening intervention can effectively prevent future malignant events in ultra-high-risk populations.

Eligibility
Participation Requirements
Sex: All
Minimum Age: 40
Maximum Age: 75
Healthy Volunteers: f
View:

• Age: Adults aged 40 to 75 years.

• Initial Colonoscopy Findings: Detection and removal of at least two advanced adenomas during the baseline colonoscopy.

• Adherence: Willingness to comply with the assigned screening protocol, including fecal immunochemical testing (FIT) and follow-up colonoscopies

Locations
Other Locations
Taiwan
National Taiwan University Hospital Hsinchu Branch
RECRUITING
Hsinchu
Fu Jen Catholic University Hospital
RECRUITING
New Taipei City
National Taiwan University Cancer Center
RECRUITING
Taipei
National Taiwan University Hospital
RECRUITING
Taipei
Contact Information
Primary
Wei-Yuan Chang, MS
wychang1005@gmail.com
+886-917-223-272
Time Frame
Start Date: 2026-07-01
Estimated Completion Date: 2031-05-01
Participants
Target number of participants: 940
Treatments
No_intervention: Standard care arm
Surveillance colonoscopy performed at third year after initial colonoscopy
Experimental: FIT arm
Intervention: Early triage using Fecal immunochemical test~Detailed: Participants in this group will undergo Fecal Immunochemical Testing (FIT) in the first and second years (FIT 1 \& 2) following their initial colonoscopy. If FIT 1 is positive, a colonoscopy will be scheduled within three months; regardless of those findings, a surveillance colonoscopy is still required in the third year. If FIT 1 is negative, the patient proceeds to FIT 2 in the second year. A positive FIT 2 likewise triggers a colonoscopy within three months, and a third-year surveillance colonoscopy remains mandatory unless the FIT 2-triggered colonoscopy occurs between 2.5 and 3.5 years after the initial procedure, in which case it fulfills the third-year requirement. If both FIT 1 and FIT 2 are negative, the participant will undergo their scheduled surveillance colonoscopy in the third year.
Related Therapeutic Areas
Sponsors
Leads: National Taiwan University Hospital

This content was sourced from clinicaltrials.gov