479 a Multicenter, Prospective, Randomized Study Comparing the Diagnostic Yield of Colon Capsule Endoscopy Versus Computed Tomographic Colonography in a Screening Population. Results of the Topaz Study

Cash, Brooks D.; Fleisher, Mark R.; Fern, Steven E.; Rajan, Elizabeth; Haithcock, Robyn; Kastenberg, David; Pound, David; Papageorgiou, Neofytos; Fernández-Urién, Ignacio; Hyman, Alain; Maklansky, Joseph; Rex, DK

doi:10.1016/j.gie.2019.04.072

Cited by 13 publications

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“…Sensitivity of CCE for polyps > 6 mm (84 %) and polyps > 10 mm (84 %) was higher than that for CTC (32 % for polyps > 6 mm and 53 % for polyps > 10 mm). Specificity was higher for CTC vs. CCE (99 % vs. 93 %, respectively) for polyps > 6 mm and comparable for polyps > 10 mm (99 % vs. 97 %, respectively) [10].…”

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confidence: 84%

“…The full text of the 35 remaining studies was reviewed, after which 23 were excluded for various reasons. A total of 13 studies were included in the review, including one additional study, which was presented during Digestive Disease Week (18 -21 May 2019, San Diego, California, USA) [10]. Two of the included studies used the same study cohort but with different study aims [11,12].…”

Section: Literature Searchmentioning

confidence: 99%

“…Eight studies used CCE as a filter test after a positive FIT result and five studies used CCE as the primary screening tool. The design of the studies differed: in eight studies both CCE and colonoscopy were performed to assess the diagnostic accuracy of CCE for CRC and polyps [11 -18]; in one study CTC or CCE was offered to FIT-positive patients who refused colonoscopy [19]; in one study the diagnostic accuracy of both CCE and CTC was compared with colonoscopy [20]; in two studies the diagnostic yield was evaluated in patients who were randomized to undergo CCE or CTC before colonoscopy [10,21]; and in one study CCE was offered to study the effect of a new examination method on the uptake of CRC screening [22].…”

Section: Study Characteristicsmentioning

confidence: 99%

“…One study used the services of Corporate Health, a company of nur-ses and physicians trained in CCE reading [11]. The remaining three studies did not mention the expertise of the viewers [10,12,13].…”

Section: Experience Of Colon Capsule Readersmentioning

confidence: 99%

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Colon capsule endoscopy in colorectal cancer screening: a systematic review

et al. 2021

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Introduction Primary colonoscopy and fecal immunochemical test (FIT) are the most commonly used colorectal cancer (CRC) screening modalities. Colon capsule endoscopy (CCE) might be an alternative. Data on the performance of CCE as a CRC screening tool in a screening population remain scarce. This is the first systematic review to provide an overview of the applicability of CCE as a CRC screening tool. Methods A systematic search was conducted of literature published up to September 2020. Studies reporting on CRC screening by second-generation CCE in an average-risk screening population were included. Results 582 studies were identified and 13 were included, comprising 2485 patients. Eight studies used CCE as a filter test after a positive FIT result and five studies used CCE for primary screening. The polyp detection rate of CCE was 24 % – 74 %. For polyps > 6 mm, sensitivity of CCE was 79 % – 96 % and specificity was 66 % – 97 %. For polyps ≥ 10 mm, sensitivity of CCE was 84 % – 97 %, which was superior to computed tomographic colonography (CTC). The CRC detection rate for completed CCEs was 93 % (25/27). Bowel preparation was adequate in 70 % – 92 % of examinations, and completion rates varied from 57 % to 92 %, depending on the booster used. No CCE-related complications were described. Conclusion CCE appeared to be a safe and effective tool for the detection of CRC and polyps in a screening setting. Accuracy was comparable to colonoscopy and superior to CTC, making CCE a good alternative to colonoscopy in CRC screening programs, although completion rates require improvement.

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confidence: 84%

Section: Literature Searchmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Experience Of Colon Capsule Readersmentioning

confidence: 99%

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Colon capsule endoscopy in colorectal cancer screening: a systematic review

et al. 2021

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“…CCE sensitivity and specificity for adenomas ≥ 6 mm were 88 % and 82 %, respectively, which seems adequate for patients who cannot undergo colonoscopy or who have had incomplete colonoscopies. Based on these results, a recent multicenter, prospective, randomized study [73] evaluated the diagnostic yield of CCE versus CTC for the identification of colonic polyps in a screening population. Results showed a higher detection rate with CCE (polyps ≥ 6 mm, 32 %; and polyps ≥ 10 mm, 14 %) compared to CTC (polyps ≥ 6 mm, 9 %; and polyps ≥ 10 mm, 6 %).…”

Section: Cce In Screening: Detection Rate and Yieldmentioning

confidence: 99%

Imaging alternatives to colonoscopy: CT colonography and colon capsule. European Society of Gastrointestinal Endoscopy (ESGE) and European Society of Gastrointestinal and Abdominal Radiology (ESGAR) Guideline – Update 2020

et al. 2020

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Main recommendations 1 ESGE/ESGAR recommend computed tomographic colonography (CTC) as the radiological examination of choice for the diagnosis of colorectal neoplasia.Strong recommendation, high quality evidence.ESGE/ESGAR do not recommend barium enema in this setting.Strong recommendation, high quality evidence. 2 ESGE/ESGAR recommend CTC, preferably the same or next day, if colonoscopy is incomplete. The timing depends on an interdisciplinary decision including endoscopic and radiological factors.Strong recommendation, low quality evidence.ESGE/ESGAR suggests that, in centers with expertise in and availability of colon capsule endoscopy (CCE), CCE preferably the same or the next day may be considered if colonoscopy is incomplete.Weak recommendation, low quality evidence. 3 When colonoscopy is contraindicated or not possible, ESGE/ESGAR recommend CTC as an acceptable and equally sensitive alternative for patients with alarm symptoms.Strong recommendation, high quality evidence.Because of lack of direct evidence, ESGE/ESGAR do not recommend CCE in this situation.Very low quality evidence.ESGE/ESGAR recommend CTC as an acceptable alternative to colonoscopy for patients with non-alarm symptoms.Strong recommendation, high quality evidence.In centers with availability, ESGE/ESGAR suggests that CCE may be considered in patients with non-alarm symptoms.Weak recommendation, low quality evidence. 4 Where there is no organized fecal immunochemical test (FIT)-based population colorectal screening program, ESGE/ESGAR recommend CTC as an option for colorectal cancer screening, providing the screenee is adequately informed about test characteristics, benefits, and risks, and depending on local service- and patient-related factors.Strong recommendation, high quality evidence.ESGE/ESGAR do not suggest CCE as a first-line screening test for colorectal cancer.Weak recommendation, low quality evidence. 5 ESGE/ESGAR recommend CTC in the case of a positive fecal occult blood test (FOBT) or FIT with incomplete or unfeasible colonoscopy, within organized population screening programs.Strong recommendation, moderate quality evidence.ESGE/ESGAR also suggest the use of CCE in this setting based on availability.Weak recommendation, moderate quality evidence. 6 ESGE/ESGAR suggest CTC with intravenous contrast medium injection for surveillance after curative-intent resection of colorectal cancer only in patients in whom colonoscopy is contraindicated or unfeasibleWeak recommendation, low quality evidence.There is insufficient evidence to recommend CCE in this setting.Very low quality evidence. 7 ESGE/ESGAR suggest CTC in patients with high risk polyps undergoing surveillance after polypectomy only when colonoscopy is unfeasible.Weak recommendation, low quality evidence.There is insufficient evidence to recommend CCE in post-polypectomy surveillance.Very low quality evidence. 8 ESGE/ESGAR recommend against CTC in patients with acute colonic inflammation and in those who have recently undergone colorectal surgery, pending a multidisciplinary evaluation.Strong recommendation, low quality evidence. 9 ESGE/ESGAR recommend referral for endoscopic polypectomy in patients with at least one polyp ≥ 6 mm detected at CTC or CCE.Follow-up CTC may be clinically considered for 6 – 9-mm CTC-detected lesions if patients do not undergo polypectomy because of patient choice, comorbidity, and/or low risk profile for advanced neoplasia.Strong recommendation, moderate quality evidence.

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Imaging alternatives to colonoscopy: CT colonography and colon capsule. European Society of Gastrointestinal Endoscopy (ESGE) and European Society of Gastrointestinal and Abdominal Radiology (ESGAR) Guideline – Update 2020

et al. 2020

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Main recommendations1. ESGE/ESGAR recommend computed tomographic colonography (CTC) as the radiological examination of choice for the diagnosis of colorectal neoplasia. Strong recommendation, high quality evidence. ESGE/ESGAR do not recommend barium enema in this setting. Strong recommendation, high quality evidence. 2. ESGE/ESGAR recommend CTC, preferably the same or next day, if colonoscopy is incomplete. The timing depends on an interdisciplinary decision including endoscopic and radiological factors. Strong recommendation, low quality evidence. ESGE/ESGAR suggests that, in centers with expertise in and availability of colon capsule endoscopy (CCE), CCE preferably the same or the next day may be considered if colonoscopy is incomplete. Weak recommendation, low quality evidence. 3. When colonoscopy is contraindicated or not possible, ESGE/ESGAR recommend CTC as an acceptable and equally sensitive alternative for patients with alarm symptoms. Strong recommendation, high quality evidence. Because of lack of direct evidence, ESGE/ESGAR do not recommend CCE in this situation. Very low quality evidence. ESGE/ESGAR recommend CTC as an acceptable alternative to colonoscopy for patients with non-alarm symptoms. Strong recommendation, high quality evidence. In centers with availability, ESGE/ESGAR suggests that CCE may be considered in patients with non-alarm symptoms. Weak recommendation, low quality evidence. 4. Where there is no organized fecal immunochemical test (FIT)-based population colorectal screening program, ESGE/ESGAR recommend CTC as an option for colorectal cancer screening, providing the screenee is adequately informed about test characteristics, benefits, and risks, and depending on local service-and patient-related factors. Strong recommendation, high quality evidence. ESGE/ESGAR do not suggest CCE as a first-line screening test for colorectal cancer. Weak recommendation, low quality evidence. 5. ESGE/ESGAR recommend CTC in the case of a positive fecal occult blood test (FOBT) or FIT with incomplete or unfeasible colonoscopy, within organized population screening programs. Strong recommendation, moderate quality evidence. ESGE/ESGAR also suggest the use of CCE in this setting based on availability. Weak recommendation, moderate quality evidence.This article is published simultaneously in the journals Endoscopy (

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479 a Multicenter, Prospective, Randomized Study Comparing the Diagnostic Yield of Colon Capsule Endoscopy Versus Computed Tomographic Colonography in a Screening Population. Results of the Topaz Study

Cited by 13 publications

References 0 publications

Colon capsule endoscopy in colorectal cancer screening: a systematic review

Colon capsule endoscopy in colorectal cancer screening: a systematic review

Imaging alternatives to colonoscopy: CT colonography and colon capsule. European Society of Gastrointestinal Endoscopy (ESGE) and European Society of Gastrointestinal and Abdominal Radiology (ESGAR) Guideline – Update 2020

Imaging alternatives to colonoscopy: CT colonography and colon capsule. European Society of Gastrointestinal Endoscopy (ESGE) and European Society of Gastrointestinal and Abdominal Radiology (ESGAR) Guideline – Update 2020

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