Colon capsule endoscopy vs. colonoscopy in patients at average or increased risk of colorectal cancer
- 16 September 2010
- journal article
- research article
- Published by Wiley in Alimentary Pharmacology & Therapeutics
- Vol. 32 (9), 1145-1153
- https://doi.org/10.1111/j.1365-2036.2010.04458.x
Abstract
Aliment Pharmacol Ther 2010; 32: 1145–1153 Summary Background Colon capsule endoscopy (CCE) is a new, non‐invasive technology. Aim To conduct a prospective, multicentre trial to compare CCE and colonoscopy in asymptomatic subjects enrolled in screening or surveillance programmes for the detection of colorectal neoplasia. Methods Patients underwent CCE on day one and colonoscopy (gold standard) on day two. CCE and colonoscopy were performed by independent endoscopists. Results A total of 545 patients were recruited. CCE was safe and well‐tolerated. Colon cleanliness was excellent or good in 52% of cases at CCE. Five patients with cancer were detected by colonoscopy, of whom two were missed by CCE. CCE accuracy for the detection of polyps ≥6 mm was 39% (95% CI 30–48) for sensitivity, 88% (95% CI 85–91) for specificity, 47% (95% CI 37–57) for positive predictive value and 85% (95% CI 82–88) for negative predictive value. CCE accuracy was better for the detection of advanced adenoma, in patients with good or excellent cleanliness and after re‐interpretation of the CCE videos by an independent expert panel. Conclusions Although well‐tolerated, CCE cannot replace colonoscopy as a first line investigation for screening and surveillance of patients at risk of cancer. Further studies should pay attention to colonic preparation (Clinicaltrial.gov number NCT00436514).Keywords
This publication has 16 references indexed in Scilit:
- Could the Colonic Capsule PillCam Colon Be Clinically Useful for Selecting Patients Who Deserve a Complete Colonoscopy? Results of Clinical Comparison With Colonoscopy in the Perspective of Colorectal Cancer ScreeningAmerican Journal Of Gastroenterology, 2010
- Capsule Endoscopy versus Colonoscopy for the Detection of Polyps and CancerNew England Journal of Medicine, 2009
- Accuracy of CT Colonography for Detection of Large Adenomas and CancersNew England Journal of Medicine, 2008
- Recent developments in capsule endoscopyGut, 2008
- PillCam colon capsule endoscopy compared with colonoscopy for colorectal tumor diagnosis: a prospective pilot studyEndoscopy, 2006
- Evaluation of the PillCam Colon capsule in the detection of colonic pathology: results of the first multicenter, prospective, comparative studyEndoscopy, 2006
- High Resolution Colonoscopy With Chromoscopy Versus Standard Colonoscopy for the Detection of Colonic Neoplasia: A Randomized StudyClinical Gastroenterology and Hepatology, 2006
- Colonoscopy practice patterns since introduction of medicare coverage for average-risk screeningClinical Gastroenterology and Hepatology, 2004
- Computed Tomographic Virtual Colonoscopy to Screen for Colorectal Neoplasia in Asymptomatic AdultsNew England Journal of Medicine, 2003
- The STARD Statement for Reporting Studies of Diagnostic Accuracy: Explanation and ElaborationAnnals of Internal Medicine, 2003