Back‐to‐back colon capsule endoscopy and optical colonoscopy in colorectal cancer screening individuals

Kobæk-Larsen, Morten; Krøijer, Rasmus; Dyrvig, Anne-Kirstine; Buijs, Maria Magdalena; Steele, Robert; Qvist, Niels; Baatrup, Gunnar

doi:10.1111/codi.13965

Cited by 61 publications

(93 citation statements)

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“…rate of polyps in this group, but only half of the polyps detected by CCE in the patients referred for colonoscopy could be found and removed. In a recent trial on CRC screening patients we found a higher polyp detection rate of 86% in complete exams, and a similar trend of CCE reporting more polyps than colonoscopy [8].…”

Section: Discussionsupporting

confidence: 65%

Colon capsule endoscopy for colonic surveillance

et al. 2019

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Aim Resources used in surveillance colonoscopies are taking up an increasing proportion of colonoscopy capacity. Colon capsule endoscopy (CCE) is a promising technique for noninvasive investigation of the colon. We aimed to investigate CCE as a possible filter in colonic surveillance with the primary outcome of reducing the number of colonoscopies.Method Patients scheduled for follow-up colonoscopy were subjected to a primary CCE and only supplemental conventional endoscopy if significant pathology was detected or if the CCE examination was incomplete. Significant pathology was defined as more than two small polyps, or one polyp greater than 9 mm or any polyp in patients with hereditary nonpolyposis colorectal cancer. Supplemental endoscopy was carried out to the extent needed to resect the detected polyps and investigate the parts of the colon that were not sufficiently visualized by the capsule.Results A total of 180 patients were included. Seventyseven patients (43%) had a complete CCE with no significant findings. A complete colonoscopy was carried out in 67 patients (37%) and 36 patients (20%) underwent a sigmoidoscopy. In the 103 patients undergoing endoscopy, 59 (57%) had no adenomas detected, 33 (32%) had 'low-risk' adenomas and 11 (11%) had 'high-risk' adenomas.Conclusion The introduction of CCE as filter test in colonic surveillance reduced colonoscopies by 43%, but this implies that untreated polyps are left behind and is not cost-effective. The CCE completion rate must be improved.What does this paper add to the literature? This is the first study to date to investigate the potential of colon capsule endoscopy as a filter test for colonoscopy in colonic surveillance. We found that it reduced the number of colonoscopies by 43%, but it requires that small polyps are left untreated; colon capsule completion rates must be improved.

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Section: Discussionsupporting

confidence: 65%

Colon capsule endoscopy for colonic surveillance

et al. 2019

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“…KRK taraması için birçok ülke yaygın olarak GGK, rektosigmoidoskopi ve kolonoskopi kullansa da, kapsül endoskopi ve sanal kolonoskopi gibi kolonu anatomik olarak inceleyen yöntemler veya deneysel aşamada olan plazmada veya gaytada çeşitli DNA ve mikroRNA moleküllerinin araştırılmasına dayanan bazı testlerle ilgili yoğun çalışmalar yapılmaktadır (Tablo 2). 9,10,11,12 Bu testlerin hangisi ya da hangilerinin kullanılacağı ile ilgili standart bir öneri yoktur. Ülkeler kanser görülme sıklığı, tarama yapacak iş gücü, ülkenin ekonomik durumu gibi bazı faktörlere bağlı olarak farklı tarama stratejileri uygulayabilmektedir.…”

Section: Discussionunclassified

Colonoscopy Findings in Patients Who Have Positive Fecal Occult Blood Test for Colorectal Cancer Screening

Mayır¹,

Ensari²,

Durhan³

et al. 2018

TJCD

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Amaç: Kolorektal kanser tarama amaçlı yapılan gaytada gizli kan testinde pozitiflik saptanarak kolonoskopi yapılan hastalarda kolonoskopi yapılma oranı, kanser, polip ve diğer kolorektal hastalık oranlarını ortaya çıkarmak amaçlanmıştır. Yöntem: Çalışmaya alınan hastaların kolonoskopi sonuçları prospektif olarak kayıt altına alındı. Bulgular: Kolonoskopi planlanan ardışık 300 hastanın sadece 127'si (%42,3) kolonoskopiyi kabul etti ve yaptırdı. Hastaların 47'sinde (%37) kolonoskopi normal idi. Kırk (%31,5) hastada benign polip, 24 (%18,9) hastada divertiküler hastalık, 40 (%31,5) hastada hemoroid veya anal fissür izlendi. Polip saptanan ve polipektomi yapılan hastalarda histopatolojik inceleme sonucunda bir (%0,8) hastada hafif şiddette displazi ve bir (%0,8) hastada malign polip saptandı. Sonuç: Gaytada gizli kan pozitifliği saptanan hastalarda kolonoskopi yaptırma oranı ve malignite saptanma oranı çok düşük bulunmuştur. Hastaların kolonoskopinin gerekliliği konusunda bildirilmesi ve kolonoskopi yaptırılmaya teşvik edilmesi kolorektal tarama programlarının başarıya ulaşmasında faydalı olacaktır. Anahtar Kelimeler: Kolorektal kanser, tarama, kolonoskopi ABSTRACT ÖZAim: To determine the rate of colonoscopies performed in patients referred for colonoscopy due to positive fecal occult blood test in colorectal cancer screening, and the rates of cancer, polyps, and other colorectal diseases detected in those who underwent colonoscopy. Method: Colonoscopy results of the patients were recorded prospectively. Results: Of the 300 consecutive patients scheduled for colonoscopy, only 127 (42.3%) underwent the procedure. Normal colonoscopy findings were seen in 47 (37%) of the patients. Forty patients (31.5%) had benign polyps, 24 (18.9%) had diverticulosis, and 40 (31.5%) had hemorrhoids or anal fissures. One patient (0.8%) had mild dysplasia and one patient (0.8%) had malignant polyp in histopathologic examination of polypectomy specimen. Conclusion: The colonoscopy rate and the rate of detection of malignancy were very low in patients who had positive fecal occult blood test in the present study. Informing patients about the need for colonoscopy and encouraging them to have colonoscopy will be helpful for the success of colorectal screening programs.

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“…Colon capsule endoscopy (CCE) is an upcoming new technology [1][2][3], which is being tested for efficacy as an alternative to conventional optical colonoscopy (OC) [2,4], in individuals with immunological fecal occult blood test (FIT), who participate in a colorectal cancer screening program. OC may be experienced as distressing, humiliating and painful, but has the capability of obtaining biopsies or excision of neoplastic lesions [5].…”

Section: Introductionmentioning

confidence: 99%

“…CCE is an examination of the colon and rectum with a camera capsule, during which the person wears a receiver in a belt around the belly [4]. The camera capsule is swallowed and takes multiple pictures, while the capsule passes through the intestine and transmits the recordings to the receiver for further analysis and interpretation.…”

Section: Introductionmentioning

confidence: 99%

“…The CCE requires a similar bowel preparation as for OC. An advantage of the CCE is the possibility to perform the investigation in the patients' home [4]. Former individuals' experiences can be of value to future patients, especially if they have a choice between methods [7], as is the case in colorectal examination [2,6,[8][9][10][11][12].…”

Section: Introductionmentioning

confidence: 99%

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Screening individuals’ experiences of colonoscopy and colon capsule endoscopy; a mixed methods study

et al. 2019

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Background: The standard investigation in colorectal cancer screening (optical colonoscopy [OC]) has a less invasive alternative with the colon capsule endoscopy (CCE). The experiences of screening individuals are needed to support a decision aid (DA) and to provide a patient view in future health technology assessments (HTA). We aimed to explore the experiences of CCE at home and OC in an outpatient clinic by screening participants who experienced both investigations on the same bowel preparation. Methods: In a mixed methods study, Danish screening individuals with a positive immunological fecal occult blood test (FIT) were consecutively included and underwent both CCE and OC in the same bowel preparation. They answered questionnaires about discomfort during CCE, delivered at home, and during a following OC in the outpatient clinic. Data were calculated in percentages and Wilcoxon signed rank test was used for comparisons. Among the 253 included patients, 10 participants were selected for a semi-structured interview about their experiences of the two examinations. The analysis and interpretation of the transcribed data were inspired by Ricoeur. Results: Questionnaire data were received from 239 participants and revealed significant less discomfort during the CCE than the OC. Interview data included explained discomfort elements in two categories: 'The examination' and 'The setting'. Compared to OC, the CCE was experienced with less pain, embarrassment and invasiveness, but presented challenges and disadvantages as well, i.e., a large camera capsule to swallow, a longer waiting time for test results after CCE and an additional OC, if pathologies were found. The home setting for CCE delivery made the participants feel less like they were ill or patients less restricted and that they received more personal care, but could induce technical challenges. MethodsA mixed methods design was chosen in order to obtain as comprehensive knowledge as possible. Within a cohort study

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Back‐to‐back colon capsule endoscopy and optical colonoscopy in colorectal cancer screening individuals

Abstract: 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.

Cited by 61 publications

References 12 publications

Colon capsule endoscopy for colonic surveillance

Colon capsule endoscopy for colonic surveillance

Colonoscopy Findings in Patients Who Have Positive Fecal Occult Blood Test for Colorectal Cancer Screening

Screening individuals’ experiences of colonoscopy and colon capsule endoscopy; a mixed methods study

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