TY - JOUR
T1 - Back-to-back colon capsule endoscopy and optical colonoscopy in colorectal cancer screening individuals
AU - Kobaek-Larsen, Morten
AU - Kroijer, Rasmus
AU - Dyrvig, Anne-Kirstine
AU - Buijs, Maria Magdalena
AU - Steele, Robert J C
AU - Qvist, Niels
AU - Baatrup, Gunnar
N1 - Colorectal Disease © 2017 The Association of Coloproctology of Great Britain and Ireland.
PY - 2018/6
Y1 - 2018/6
N2 - Aim: The aim was to determine the polyp detection rate and per-patient sensitivity for polyps > 9 mm of colon capsule endoscopy (CCE) compared with colonoscopy as well as the diagnostic accuracy of CCE. Method: Individuals who had a positive immunochemical faecal occult blood test during screening had investigator blinded CCE and colonoscopy. Participants underwent repeat endoscopy if significant lesions detected by CCE were considered to have been missed by colonoscopy. Results: There were 253 participants. The polyp detection rate was significantly higher in CCE compared with colonoscopy (P = 0.02). The per-patient sensitivity for > 9 mm polyps for CCE and colonoscopy was 87% (95% CI: 83–91%) and 88% (95% CI: 84–92%) respectively. In participants with complete CCE and colonoscopy examinations (N = 126), per-patient sensitivity of > 9 mm polyps in CCE (97%; 95% CI: 94–100%) was superior to colonoscopy (89%; 95% CI: 84–94%). A complete capsule endoscopy examination (N = 134) could detect patients with intermediate or greater risk (according to the European guidelines) with an accuracy, sensitivity, specificity and positivity rate of 79%, 93%, 69% and 58% respectively, using a cut-off of at least one polyp > 10 mm or more than two polyps. Conclusion: CCE is superior to colonoscopy in polyp detection rate and per-patient sensitivity to > 9 mm polyps, but only in complete CCE examinations. The rate of incomplete CCE examinations must be improved.
AB - Aim: The aim was to determine the polyp detection rate and per-patient sensitivity for polyps > 9 mm of colon capsule endoscopy (CCE) compared with colonoscopy as well as the diagnostic accuracy of CCE. Method: Individuals who had a positive immunochemical faecal occult blood test during screening had investigator blinded CCE and colonoscopy. Participants underwent repeat endoscopy if significant lesions detected by CCE were considered to have been missed by colonoscopy. Results: There were 253 participants. The polyp detection rate was significantly higher in CCE compared with colonoscopy (P = 0.02). The per-patient sensitivity for > 9 mm polyps for CCE and colonoscopy was 87% (95% CI: 83–91%) and 88% (95% CI: 84–92%) respectively. In participants with complete CCE and colonoscopy examinations (N = 126), per-patient sensitivity of > 9 mm polyps in CCE (97%; 95% CI: 94–100%) was superior to colonoscopy (89%; 95% CI: 84–94%). A complete capsule endoscopy examination (N = 134) could detect patients with intermediate or greater risk (according to the European guidelines) with an accuracy, sensitivity, specificity and positivity rate of 79%, 93%, 69% and 58% respectively, using a cut-off of at least one polyp > 10 mm or more than two polyps. Conclusion: CCE is superior to colonoscopy in polyp detection rate and per-patient sensitivity to > 9 mm polyps, but only in complete CCE examinations. The rate of incomplete CCE examinations must be improved.
KW - Colon capsule endoscopy
KW - colonoscopy
KW - colorectal cancer screening
U2 - 10.1111/codi.13965
DO - 10.1111/codi.13965
M3 - Journal article
C2 - 29166546
SN - 1463-1318
VL - 20
SP - 479
EP - 485
JO - Colorectal Disease
JF - Colorectal Disease
IS - 6
ER -