Colonoscopy vs. Stool-Based Testing

Audrey H. Calderwood, MD, MS

A research team at Dartmouth-Hitchcock was approved for a $32.7 million funding award by the Patient-Centered Outcomes Research Institute (PCORI) to study colonoscopy versus stool-based testing among older adults with a history of colon polyps.  

The study is led by Audrey H. Calderwood, MD, MS, director of the Comprehensive Gastroenterology Center and associate professor of medicine at Geisel School of Medicine at Dartmouth and the Dartmouth Institute for Health Policy and Clinical Practice (TDI).

“The trial will compare colonoscopy and stool-based testing for the prevention of colorectal cancer in adults 70 and older who have had prior small colon polyps,” Calderwood said. “In addition, we are gathering information on important patient-centered outcomes, including trust in testing, cancer worry, perceived cancer susceptibility and emotional benefits of surveillance.”

The results of the study “will bring meaningful change in the delivery of colorectal cancer prevention for older adults by offering a safe and convenient alternative to colonoscopy,” Calderwood added.

The study was selected through a PCORI initiative to support large-scale, high-impact comparative effectiveness research trials in a multi-phase format allowing for testing and refinement of the study approach. The competitive review process allowed patients, caregivers and other stakeholders to join scientists in evaluating proposals.

“I am very excited to work together with our team of patient partners and stakeholders, including primary care providers, advocacy organizations, and medical system and population health representatives,” Calderwood said.

Co-investigators include Douglas J. Robertson, MD, MPH, chief of Gastroenterology at the White River Junction VA  and professor of medicine at TDI, and Karen E. Schifferdecker, PhD, MPH, director of the Center for Program Design and Evaluation at Dartmouth and associate professor of community and family medicine at TDI.

“The study has the potential to fill an important evidence gap relevant to a range of health care decision-makers and help them better assess their care options,” said PCORI Executive Director Nakela L. Cook, MD, MPH. “We look forward to following the study’s progress and working with Dr. Calderwood to share her results.”