Care for Colon 2015 (CFC2015)

Colon Capsule Endoscopy in Bowel Cancer Screening. A Randomized Controlled Trial

The investigatior believe that implementing camera capsule endoscopy as a filter test to colonoscopy will increase screening participation, increase the number of individuals with detected intermediate- high risk adenomas or cancer, reduce the colonoscopy demand and reduce the number of complications.

Study Overview

• Status: Completed
• Conditions: Colorectal Cancer; Adenoma
• Intervention / Treatment: Device: Camera Capsule Endoscopy/ PillCam

Detailed Description

The Danish national colorectal cancer screening program includes all citizens aged 50-74 years, who are invited biennially to a fecal test for invisible blood in the stool. If the test is positive the citizen is invited for a colonoscopy. 90% of the test-positive undergo colonoscopy. The detected cancers are at a significant earlier stage and survival from screening detected cancer is higher. It is also expected that cancer incidence will drop due to removal of the advanced adenomas before they develop into cancer. Although initial results are positive, there is room for improvement. Additionally there are rare but serious complications to colonoscopy in the form of bleeding or bowel perforation.

Through four years the investigators have tested the colon capsule endoscopy method, and find that the investigation is associated with significantly less discomfort and that the diagnostic ability to find polyps > 1 cm is better than colonoscopy.

• Study Type: Interventional
• Enrollment (Actual): 2031
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Denmark
  • Svendborg, Denmark, 5700
    • Odense University Hospital, Svendborg Sygehus

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 50 years to 74 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Participation in the Danish colorectal screening program

Exclusion Criteria:

• None

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Diagnostic
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: The intervention group; If the FIT test is returned and positive the individual can choose either Camera Capsule Endoscopy (CCE) or Optical colonoscopy (OC) as the primary bowel investigation. If OC is chosen, it is performed as standard and the participant outcomes remains analyzed in the intervention group as intention to treat. If CCE is chosen an out-clinic CCE will be done at one of four regional sites. Overall and segmental bowel preparation grade (Leighton-Rex 1-4) and all pathological findings are reported. If the anal verge is identified without video blackout in the colon the transit is considered complete. Any incomplete CCE investigation will be followed by standard optical endoscopy to the extent needed to investigate the proportion of the colon not visualized by the capsule and remove any detected polyps. If the CCE is complete with complete transit and adequate preparation, individuals with more than two polyps or one polyp over 9 mm will be referred for colonoscopy.	Device: Camera Capsule Endoscopy/ PillCam; Camera Capsule Endoscopy in screening
No Intervention: The control group; The control group will be invited to screening as usual. The intervention group will be informed that if the fecal test is returned and positive they can either choose to have an initial colon capsule endoscopy, and only colonoscopy if significant findings are made or an initial colonoscopy as usual.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
CCE detection rate of polyps compared to OC	The investigators aim to conduct a large scale randomized trial to investigate the implementation of CCE as part of the Danish screening protocol.	Within 30 days

Collaborators and Investigators

• Sponsor: Odense University Hospital

Publications and helpful links

General Publications

• Deding U, Boggild H, Baatrup G, Kaalby L, Hjelmborg J, Thygesen MK, Schelde-Olesen B, Kobaek-Larsen M; CareForColon2015 study group. Socioeconomic differences in expected discomfort from colonoscopy and colon capsule endoscopy. Prev Med. 2023 Aug;173:107593. doi: 10.1016/j.ypmed.2023.107593. Epub 2023 Jun 24.
• Deding U, Boggild H, Kaalby L, Hjelmborg J, Kobaek-Larsen M, Thygesen MK, Schelde-Olesen B, Bjorsum-Meyer T, Baatrup G; CareForColon2015 study group. Socioeconomic differences in discrepancies between expected and experienced discomfort from colonoscopy and colon capsule endoscopy. Heliyon. 2024 Jul 8;10(14):e34274. doi: 10.1016/j.heliyon.2024.e34274. eCollection 2024 Jul 30.
• Baatrup G, Bjorsum-Meyer T, Kaalby L, Schelde-Olesen B, Kobaek-Larsen M, Koulaouzidis A, Kroijer R, Al-Najami I, Buch N, Hogh A, Qvist N, Thygesen MK, Deding U; CareForColon2015 study group. Choice of colon capsule or colonoscopy versus default colonoscopy in FIT positive patients in the Danish screening programme: a parallel group randomised controlled trial. Gut. 2025 Apr 10:gutjnl-2024-333687. doi: 10.1136/gutjnl-2024-333687. Online ahead of print.
• Deding U, Bjorsum-Meyer T, Kaalby L, Kobaek-Larsen M, Thygesen MK, Madsen JB, Kroijer R, Baatrup G. Colon capsule endoscopy in colorectal cancer screening: Interim analyses of randomized controlled trial CareForColon2015. Endosc Int Open. 2021 Nov 12;9(11):E1712-E1719. doi: 10.1055/a-1546-8727. eCollection 2021 Nov.
• Kaalby L, Deding U, Kobaek-Larsen M, Havshoi AV, Zimmermann-Nielsen E, Thygesen MK, Kroeijer R, Bjorsum-Meyer T, Baatrup G. Colon capsule endoscopy in colorectal cancer screening: a randomised controlled trial. BMJ Open Gastroenterol. 2020 Jun;7(1):e000411. doi: 10.1136/bmjgast-2020-000411.
• Schelde-Olesen B, Koulaouzidis A, Deding U, Toth E, Dabos KJ, Eliakim A, Carretero C, Gonzalez-Suarez B, Dray X, de Lange T, Beaumont H, Rondonotti E, Kopylov U, Ellul P, Perez-Cuadrado-Robles E, Robertson A, Stenfors I, Bojorquez A, Piccirelli S, Raabe GG, Margalit-Yehuda R, Barba I, Scardino G, Ouazana S, Bjorsum-Meyer T. Bowel cleansing quality evaluation in colon capsule endoscopy: what is the reference standard? Therap Adv Gastroenterol. 2024 Oct 23;17:17562848241290256. doi: 10.1177/17562848241290256. eCollection 2024.

Study record dates

Study Major Dates

• Study Start (Actual): August 3, 2020
• Primary Completion (Actual): January 31, 2024
• Study Completion (Actual): October 1, 2024

Study Registration Dates

• First Submitted: August 5, 2019
• First Submitted That Met QC Criteria: August 7, 2019
• First Posted (Actual): August 8, 2019

Study Record Updates

• Last Update Posted (Estimated): October 2, 2025
• Last Update Submitted That Met QC Criteria: September 29, 2025
• Last Verified: April 1, 2024

More Information

Terms related to this study

• Keywords: Colorectal cancer; Colorectal cancer screening; Optical colonoscopy; Camera Capsule Endoscopy
• Additional Relevant MeSH Terms: Neoplasms by Site; Neoplasms; Intestinal Diseases; Neoplasms by Histologic Type; Gastrointestinal Neoplasms; Digestive System Neoplasms; Digestive System Diseases; Gastrointestinal Diseases; Intestinal Neoplasms; Rectal Diseases; Neoplasms, Glandular and Epithelial; Colonic Diseases; Colorectal Neoplasms; Adenoma; Diagnostic Techniques and Procedures; Diagnosis; Surgical Procedures, Operative; Minimally Invasive Surgical Procedures; Diagnostic Techniques, Surgical; Endoscopy
• Other Study ID Numbers: Other Grant/Funding Number: Community Foundation of Greater Birmingham Women's Breast Health Fund

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: Yes
• product manufactured in and exported from the U.S.: Yes