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dc.contributor.authorHull, M.A.*
dc.contributor.authorSandell, A.C.*
dc.contributor.authorMontgomery, A.A.*
dc.contributor.authorLogan, R.F.A.*
dc.contributor.authorClifford, G.M.*
dc.contributor.authorRees, C.J.*
dc.contributor.authorLoadman, Paul M.*
dc.contributor.authorWhitham, D.*
dc.date.accessioned2016-10-06T14:57:46Z
dc.date.available2016-10-06T14:57:46Z
dc.date.issued2013-07-29
dc.identifier.citationHull MA, Sandell AC, Montgomery AA, Logan RFA, Clifford GM, Rees CJ, Loadman PM and Whitham D (2013) A randomized controlled trial of eicosapentaenoic acid and/or aspirin for colorectal adenoma prevention during colonoscopic surveillance in the NHS Bowel Cancer Screening Programme (The seAFOod Polyp Prevention Trial): study protocol for a randomized controlled trial. Trials. 14(1): 237.en_US
dc.identifier.urihttp://hdl.handle.net/10454/9532
dc.descriptionYesen_US
dc.description.abstractThe naturally-occurring omega (ω)-3 polyunsaturated fatty acid (PUFA) eicosapentaenoic acid (EPA) reduces colorectal adenoma (polyp) number and size in patients with familial adenomatous polyposis. The safety profile and potential cardiovascular benefits associated with ω-3 PUFAs make EPA a strong candidate for colorectal cancer (CRC) chemoprevention, alone or in combination with aspirin, which itself has recognized anti-CRC activity. Colorectal adenoma number and size are recognized as biomarkers of future CRC risk and are established as surrogate end-points in CRC chemoprevention trials. The seAFOod Polyp Prevention Trial is a randomized, double-blind, placebo-controlled, 2 × 2 factorial ‘efficacy’ study, which will determine whether EPA prevents colorectal adenomas, either alone or in combination with aspirin. Participants are 55–73 year-old patients, who have been identified as ‘high risk’ (detection of ≥5 small adenomas or ≥3 adenomas with at least one being ≥10 mm in diameter) at screening colonoscopy in the English Bowel Cancer Screening Programme (BCSP). Exclusion criteria include the need for more than one repeat endoscopy within the three-month BCSP screening period, malignant change in an adenoma, regular use of aspirin or non-aspirin non-steroidal anti-inflammatory drugs, regular use of fish oil supplements and concomitant warfarin or anti-platelet agent therapy. Patients are randomized to either EPA-free fatty acid 1 g twice daily or identical placebo AND aspirin 300 mg once daily or identical placebo, for approximately 12 months. The primary end-point is the number of participants with one or more adenomas detected at routine one-year BCSP surveillance colonoscopy. Secondary end-points include the number of adenomas (total and ‘advanced’) per patient, the location (left versus right colon) of colorectal adenomas and the number of participants re-classified as ‘intermediate risk’ for future surveillance. Exploratory end-points include levels of bioactive lipid mediators such as ω-3 PUFAs, resolvin E1 and PGE-M in plasma, urine, erythrocytes and rectal mucosa in order to gain insights into the mechanism(s) of action of EPA and aspirin, alone and in combination, as well as to discover predictive biomarkers of chemopreventive efficacy. The recruitment target is 904 patients.en_US
dc.description.sponsorshipMedical Research Council (MRC) and managed by the National Institute for Health Research (NIHR) on behalf of the MRC-NIHR partnershipen_US
dc.language.isoenen_US
dc.relation.isreferencedbyhttp://dx.doi.org/10.1186/1745-6215-14-237en_US
dc.rights© 2013 Hull et al. This is an Open Access article distributed under the terms of the Creative Commons CC-BY license (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.en_US
dc.subjectAspirin; Colorectal adenoma; Colorectal cancer; Eicosapentaenoic acid; Omega-3 polyunsaturated fatty aciden_US
dc.titleA randomised controlled trial of eicosapentaenoic acid and/or aspirin for colorectal adenoma (or polyp) prevention during colonoscopic surveillance in the NHS Bowel Cancer Screening Programme: The seAFOod (Systematic Evaluation of Aspirin and Fish Oil) Polyp Prevention Trialen_US
dc.status.refereedyesen_US
dc.date.Accepted2013-07-13
dc.typeArticleen_US
dc.type.versionpublished version paperen_US
refterms.dateFOA2018-07-25T15:01:54Z


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