The FORTE trial is a large randomized clinical study evaluating whether patients with 1–2 non-advanced adenomatous polyps benefit from earlier surveillance colonoscopy at 5 years compared to delaying follow-up until 10 years. While current guidelines recommend repeat colonoscopy within a 5–10 year window for these low-risk patients, there is limited randomized evidence to determine the optimal interval—leading to wide variation in practice and frequent overuse of early surveillance.
Sponsored by NRG Oncology and enrolling an estimated 9,500 participants aged 45–70, the study will compare colorectal cancer incidence, advanced adenoma detection, cancer mortality, and late-stage disease outcomes between individuals randomized to 10-year surveillance alone versus those undergoing colonoscopy at both 5 and 10 years. As detection of small, non-advanced adenomas continues to rise with improving adenoma detection rates, findings from the FORTE trial are expected to provide long-awaited evidence to guide surveillance timing and potentially reduce unnecessary colonoscopy utilization in low-risk populations.