Systematic review and meta-analysis of colon capsule endoscopy accuracy for colorectal cancer screening. An alternative during the Covid-19 pandemic?

Sulbaran, Marianny; Bustamante-Lopez, Leonardo Alfonso; Bernardo, Wanderley Marques; Sakai, Christiano; Sakai, Paulo; Nahas, Sérgio Carlos; Moura, Eduardo Guimarães Hourneaux de

doi:10.1177/09691413221074803

Cited by 10 publications

(13 citation statements)

References 44 publications

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“… 32 Colon capsule endoscopy has also been advocated as an alternative for CRC screening after a positive FIT, as it can be performed as an out-of-clinic procedure, avoiding patients to attend medical facilities, and it has demonstrated a high diagnostic accuracy (area under receiver operating curve 0.963 for polyps at least 6 mm); hence, it may be used to filter patients in need of a colonoscopy. 33 In fact, current CRC screening guidelines recommend this technique as a valid alternative for individuals unable or unwilling to undergo colonoscopy. 34 Computed tomography colonography is also recommended in this setting.…”

Section: Impact Of Covid-19 Pandemic In Crc Screeningmentioning

confidence: 99%

The impact of COVID-19 pandemic in the diagnosis and management of colorectal cancer patients

Domper-Arnal

Mallada

Lanas

2022

Therap Adv Gastroenterol

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The novel coronavirus disease 2019 (COVID-19) pandemic has posed an unprecedented challenge to healthcare systems worldwide, causing downscaling of almost all other activities, especially in its early stages. Currently, the availability of vaccines along with the spread of new viral variants has modified the epidemiology of the disease, and the previous activity is being gradually resumed in most healthcare facilities. In this review, we have summarized the influence of the COVID-19 pandemic in the diagnosis and management of colorectal cancer (CRC) patients. Population-based screening with either colonoscopy or fecal occult blood tests has proven to reduce CRC incidence and mortality, so screening programs have been implemented in most western countries. However, during the first COVID-19 wave, most of these programs had to be disrupted temporarily. In this review, we have thoroughly analyzed the consequences of these disruptions of screening programs as well as of the forced delays in diagnostic and therapeutic services on CRC prognosis, although its exact impact cannot be exactly measured yet. In any way, strategies to minimize its effect, such as catch-up strategies expanding the colonoscopy capacity or using fecal occult blood concentration and other risk factors to prioritize patients, are urgently needed. The COVID-19 pandemic has also led to a change in CRC patient presentation, with an overall temporary decreased incidence due to postponed diagnoses, but with more patients presenting in need of an emergency admission or with symptoms. Finally, changes in treatment approaches in CRC patients have been reported during the pandemic, namely a drop in the proportion of laparoscopic surgeries or a rise in short-term radiotherapy courses. We have therefore aimed to summarize the available evidence to guide the healthcare professionals treating CRC patients to choose the best treatment options in the current pandemic situation.

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Section: Impact Of Covid-19 Pandemic In Crc Screeningmentioning

confidence: 99%

The impact of COVID-19 pandemic in the diagnosis and management of colorectal cancer patients

Domper-Arnal

Mallada

Lanas

2022

Therap Adv Gastroenterol

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“…For people with no risk factors, screening starts at age 50-years-old. People with a close relative (parent or sibling) with colorectal cancer or polyps will start screening at age 40-years-old or at 10 years before the youngest age at which a relative was diagnosed[ 7 , 20 - 27 ]. These patients will often undergo screening every 5 years, even if their test is normal.…”

Section: Screening and Surveillance For Colorectal Cancermentioning

confidence: 99%

“…These patients will often undergo screening every 5 years, even if their test is normal. Less common types of inherited colon cancer (hereditary non-polyposis colon cancer and familial adenomatous polyposis) may require more frequent screening, beginning at a much earlier age[ 7 , 20 - 27 ]. There are various methods of screening as described below.…”

Section: Screening and Surveillance For Colorectal Cancermentioning

confidence: 99%

“…It is repeated every 10 years[ 20 , 23 , 43 ]. Capsule colonoscopy is a painless procedure using a pill camera to view the entire colon and rectum [ 27 , 44 ]. Computed tomography colonography has been shown to have comparable sensitivity and specificity as colonoscopy but lacks the tissue sampling advantage of the colonoscopy[ 20 , 23 , 43 ].…”

Section: Screening and Surveillance For Colorectal Cancermentioning

confidence: 99%

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Clinical presentation, management, screening and surveillance for colorectal cancer during the COVID-19 pandemic

Akbulut¹,

Hargura²,

Garzali³

et al. 2022

WJCC

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Management of colorectal cancer (CRC) was severely affected by the changes implemented during the pandemic, and this resulted in delayed elective presentation, increased emergency presentation, reduced screening and delayed definitive therapy. This review was conducted to analyze the impact of the coronavirus disease 2019 (COVID-19) pandemic on management of CRC and to identify the changes made in order to adapt to the pandemic. We performed a literature search in PubMed, Medline, Index Medicus, EMBASE, SCOPUS, Reference Citation Analysis ( ) and Google Scholar using the following keywords in various combinations: Colorectal cancer, elective surgery, emergency surgery, stage upgrading, screening, surveillance and the COVID-19 pandemic. Only studies published in English were included. To curtail the spread of COVID-19 infection, there were modifications made in the management of CRC. Screening was limited to high risk individuals, and the screening tests of choice during the pandemic were fecal occult blood test, fecal immunochemical test and stool DNA testing. The use of capsule colonoscopy and open access colonoscopy was also encouraged. Blood-based tests like serum methylated septin 9 were also encouraged for screening of CRC during the pandemic. The presentation of CRC was also affected by the pandemic with more patients presenting with emergencies like obstruction and perforation. Stage migration was also observed during the pandemic with more patients presenting with more advanced tumors. The operative therapy of CRC was altered by the pandemic as more emergencies surgeries were done, which may require exteriorization by stoma. This was to reduce the morbidity associated with anastomosis and encourage early discharge from the hospital. There was also an initial reduction in laparoscopic surgical procedures due to the fear of aerosols and COVID-19 infection. As we gradually come out of the pandemic, we should remember the lessons learned and continue to apply them even after the pandemic passes.

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“…These studies signaled the markedly improved sensitivity and accuracy of CCE-2 compared to CCE-1. Several subsequent controlled studies have reported the efficacy of CCE-2 in identifying colonic polyps [ 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 ].…”

Section: 2nd-generation Colon Capsule Endoscopy and Polyp Detectionmentioning

confidence: 99%

Colon Capsule Endoscopy in the Diagnosis of Colon Polyps: Who Needs a Colonoscopy?

et al. 2022

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Colon screening programs have reduced colon cancer mortality. Population screening should be minimally invasive, safe, acceptably sensitive, cost-effective, and scalable. The range of screening modalities include guaiac or immunochemical fecal occult blood testing and CT colonography and colonoscopy. A number of carefully controlled studies concur that second-generation capsule endoscopy has excellent sensitivity for polyp detection and a high negative predictive value. Colon capsules fulfill the screening expectation of safety, high sensitivity for polyp detection, and patient acceptance, and appear to straddle the divide between occult blood testing and colonoscopy. While meeting these criteria, there remains the challenges of scaling, capsule practitioner training, resource allocation, and implementing change of practice. Like CT colonography, capsule screening presents the clinician with a decision on the threshold for colonoscopy referral. Overall, colon capsules are an invaluable tool in polyp detection and colon screening and offer a filter that determines “who needs a colonoscopy?”.

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Systematic review and meta-analysis of colon capsule endoscopy accuracy for colorectal cancer screening. An alternative during the Covid-19 pandemic?

Cited by 10 publications

References 44 publications

The impact of COVID-19 pandemic in the diagnosis and management of colorectal cancer patients

The impact of COVID-19 pandemic in the diagnosis and management of colorectal cancer patients

Clinical presentation, management, screening and surveillance for colorectal cancer during the COVID-19 pandemic

Colon Capsule Endoscopy in the Diagnosis of Colon Polyps: Who Needs a Colonoscopy?

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