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This study aims to determine the performance of the Exact IBD-ACRN surveillance test to
detect colorectal cancer (CRC) and colorectal neoplasia in patients with inflammatory bowel
disease (IBD). Patients with an IBD diagnosis for at least eight years or diagnosis of
primary sclerosing cholangitis (PSC) and who are eligible for CRC screening are eligible to
participate in this study. Enrolled subjects will collect a stool sample for the Exact
IBD-ACRN surveillance test. Subjects must have undergone colonoscopy no more than 90 days
prior to enrollment and will undergo colonoscopy or surgical intervention within 120 days of
enrollment. Tissue diagnosis of CRC will be established by histopathologic examination.

This is a prospective, cross sectional, multi-center study to determine the sensitivity and
specificity of the Exact IBD-ACRN surveillance test for detecting CRC alone and in
combination with high grade dysplasia (HGD) and low grade dysplasia (LGD) associated with
IBD and advanced adenoma in IBD patients with disease duration greater than 8 years or PSC
diagnosis. Enrolled subjects will provide a single stool sample for the Exact IBD-ACRN
surveillance test, no sooner than 7 days following their most recent pre-enrollment
colonoscopy, within 30 days of enrollment and prior to initiating bowel prep for either the
post-enrollment colonoscopy (surveillance or repeat), or surgical intervention. Stool
samples will be tested using the Exact IBD-ACRN surveillance test and results compared to
the colonoscopy and corresponding diagnostic histopathology results from biopsied, and any
subsequently excised, lesions to establish sensitivity and specificity of the Exact IBD-ACRN
surveillance test. All post-enrollment colonoscopies or surgical interventions must be
performed within 60 days of enrollment.

The primary objective of this study is to determine the sensitivity and specificity of the
Exact IBD-ACRN surveillance test for CRC in IBD patients with disease duration of at least
eight years or diagnosis of PSC. Tissue diagnosis of CRC will be established by
histopathology examination. The secondary objective is to determine the sensitivity and
specificity of the Exact IBD-ACRN surveillance test to detect ACRN in IBD patients with
disease duration of at least eight years or diagnosis of PSC.

Enrollment will continue until at least 35 CRC; 15 HGD and 315 negative subject samples have
been obtained. There is no specific recruitment goal for IBD associated LGD or LGD
associated with advanced adenoma (AA).

Inclusion Criteria:

- Male or female 18-84 years of age, inclusive.

- Diagnosis of IBD or a diagnosis of PSC with IBD prior to enrollment date of this
study.

- Must be a candidate for a surveillance colonoscopy, with the intention of
CRC/dysplasia surveillance, or a candidate for surgical intervention based on prior
histological confirmation of HGD or CRC.

- Written informed consent document signed and dated by the subject or legally
acceptable representative.

Exclusion Criteria:

- Any condition that in the opinion of the investigator should preclude participation
in the study.