Capsule colonoscopy increases uptake of colorectal cancer screening

Abstract

BackgroundScreening colonoscopy effectiveness is hampered by limited adherence by the general population. The present prospective study was performed to evaluate whether adding capsule colonoscopy to the endoscopic screening options increases uptake.MethodsInvitation letters were sent to 2150 persons above the age of 55 insured with a German medical insurance company in the area of Rinteln, Lower Saxony with a baseline spontaneous annual screening colonoscopy uptake of 1 %. Both capsule or conventional colonoscopy were offered. Interested persons were given information about the two screening options by four local gastroenterologists and examinations were then performed according to screenees’ final choice.Results154 persons sought further information, and 34 and 90 underwent conventional and capsule colonoscopy, respectively. Colonoscopy uptake was thus increased by the invitation process by 60 % (1.6 % vs. 1 %; p = 0.075), while the option of capsule endoscopy led to a fourfold increase of screening uptake (4.2 % vs. 1 %, p < 0.001). Despite similar age distribution in both sex groups, uptake in men was significantly higher (5.6 % vs. 2.8 %, p = 002). However, overall adenoma yield was not different in both groups.ConclusionsThe present study suggests that offering the option of capsule colonoscopy increases uptake of endoscopic colorectal cancer screening. However, capsule endoscopy sensitivity for adenoma detection needs to be improved.

Uptake of Colon Capsule Endoscopy vs Colonoscopy for Screening Relatives of Patients With Colorectal Cancer

“…The trial registered as ClinicalTrials.gov number NCT01557101 complied with the CONSORT extension for pragmatic trials. 19 Inclusion criteria were: asymptomatic FDR ≥40 years of age or ten years less than the youngest relative with CRC. Exclusion criteria were: previous CRC screening; history of colorectal neoplasia or inflammatory bowel disease; hereditary CRC; gastrointestinal surgery; pregnancy; allergy or other severe comorbidity (mean life expectancy of <5 years) or major limitation of physical activity (performance status ≥2); and contraindication for bisacodyl, polyethylen glycol or phosphates.…”

Darmkrebsvorsorge: Wie kann die Akzeptanz in der Bevölkerung erhöht werden?

“…Vor allem bei der risikoadaptierten Darmkrebsfrüherkennung hat es lange gedauert, bis die Einsicht wuchs, dass v. a. bei familiärem Darmkrebsrisiko oder genetischem Risiko ein früherer Beginn der Vorsorgeuntersuchungen zwingend ist. Nachdem die S3-Leitlinien der Fachgesellschaften zum kolorektalen Karzinom dies eindeutig formuliert und den Zeitrahmen deutlich früher gelegt haben, besteht heute kein Zweifel mehr daran, dass bei einem derart Betroffenen mindestens 10 Jahre vor dem Erkrankungsalter des Indexpatienten eine Darmspiegelung erfolgen sollte [10]. Das KFRG trägt dieser Entwicklung mit der Möglichkeit der Flexibilisierung der Altersgrenzen durchaus Rechnung.…”

Colon Capsule Endoscopy: Quo Vadis?

“…In a prospective study performed in Germany to examine whether colon capsule endoscopy could increase adherence to screening colonoscopy in a healthy population Groth et al found that offering capsule endoscopy led to a fourfold increase of screening uptake compared to standard colonoscopy [10].…”