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600 active trials for Colorectal Cancer

Scaling CRC Screening Through Outreach, Referral, and Engagement (SCORE)

Colorectal cancer (CRC) is a leading cause of cancer death in the United States. In North Carolina, as in many parts of the United States, CRC screening is substantially underused in vulnerable and marginalized populations. Uninsured, underinsured, and medically underserved populations rely on federally qualified health centers (FQHCs) for their healthcare and thus patients served by North Carolina's FQHCs are particularly likely to benefit from efforts and resources to improve CRC screening. The United States Preventive Services Task Force recommends several tests to screen for CRC, including annual screening with a fecal immunochemical test (FIT), for patients ages 50-75 years. Programs that include mailing FITs to patients have shown promise as an effective means of increasing CRC screening, including for vulnerable populations. This randomized controlled trial is designed to assess the effectiveness, feasibility, acceptability, and cost-effectiveness of mailing FITs from a central location to patients served by FQHCs. This study also assesses the effectiveness, feasibility, acceptability, and costs of delivering patient navigation from a central location to facilitate follow-up colonoscopy for patients with a positive (abnormal) FIT result. To assess adherence to the United States Preventive Services Task Force recommendations for annual screening with FIT, we will mail eligible participants one FIT per year for up to two years.

Start: July 2020
Hepatic Artery Infusion Pump Chemotherapy With Floxuridine and Dexamethasone in Combination With Systemic Chemotherapy for Patients With Colorectal Cancer Metastatic to the Liver

Background: Many people with colorectal cancer get liver metastases. Standard treatment for this is a combination of chemotherapy drugs. Directing the chemotherapy to the liver may be effective. A device that does this a pump that delivers drugs over 2 weeks at constant rate into the hepatic artery. The person s body temperature causes the drug to flow from the pump. Researchers want to see if this helps people with colorectal metastases to the liver. Objective: To study the effectiveness of a hepatic artery infusion pump at treating colorectal metastases to the liver. Eligibility: Adults at least 18 years old with colorectal metastases to the liver Design: Participants will be screened with: Medical history Physical exam Heart, blood, and urine tests Scans Participants will stay in the hospital a few days. A small plastic tube (catheter) will be inserted in an artery into the liver. The catheter will be attached to the pump. That will lie under the skin on the abdomen. It will be small and participants will be able to feel it. Participants will get treatment in 28-day cycles. Every Day 1, they will have physical exam, symptom review, and blood tests. Every 2 weeks, they will come to the clinic to get chemotherapy by a catheter or port. Every 12 weeks, they will have a scan. Tissue samples may be taken during the study. When they finish the drug, participants may have the pump removed. They will repeat the Day 1 tests. They will be called every 6 months to see how they are doing. Sponsoring Institute: National Cancer Institute

Start: June 2019
Breakthrough Improvement Collaborative for ColoRectal Cancer (BIC4CRC)

Colorectal cancer is the most common cancer in Europe and the third worldwide. Approximately 1 in 20 men and 1 in 35 women will develop colorectal cancer at some moment in their life. In Flanders, in 2014, there was an increase in the detection of colorectal cancer with 21% compared to 2013. Early detection improves the prognosis for the patient. In this early stage, colorectal surgery is one of the most important treatments, but it is also complex and has a high complication rate. However, over the last decade, surgical care for patients with colorectal cancer has become more standardized. The use of structured care methods, such as care pathways and protocols, has helped in standardizing care processes. Specifically for patients with colorectal cancer, perioperative care has shifted with the implementation of Enhanced Recovery After Surgery (ERAS) programs. The goal of ERAS- protocols is to optimize the interventions during the perioperative hospitalization period and reduce postoperative complications. Despite the increasing evidence in favor of the use of these standardized protocols, adherence and implementation in daily practice remains challenging. The primary goal of this quality improvement project is to enhance the standardization of key interventions in the ERAS care process for patients undergoing colorectal surgery. Therefore, adherence to the ERAS-guidelines will be investigated and hospitals will receive feedback to set up improvement initiatives. Moreover, interactive group sessions and on-site training activities will stimulate knowledge sharing and define best practices.

Start: March 2018