Colon Capsule Endoscopy compared to Conventional Colonoscopy under routine screening conditions

Julia B Pilz, Susanne Portmann, Shajan Peter, Christoph Beglinger, Lukas Degen, Julia B Pilz, Susanne Portmann, Shajan Peter, Christoph Beglinger, Lukas Degen

Abstract

Background: Colonoscopy (CSPY) for colorectal cancer screening has several limitations. Colon Capsule Endoscopy (PillCam Colon, CCE) was compared to CSPY under routine screening conditions.

Methods: We performed a prospective, single-center pilot study at a University Hospital. Data were obtained from November 2007 until May 2008. Patients underwent CCE on Day 1 and CSPY on Day 2. Outcomes were evaluated regarding sensitivity and specificity of polyp detection rate, with a significance level set at >5 mm.

Results: 59 individuals were included in this study, the results were evaluable in 56 patients (males 34, females 22; median age 59). CCE was complete in 36 subjects. Polyp detection rate for significant polyps was 11% on CSPY and 27% on CCE.6/56 (11%) patients had polyps on CSPY not detected on CCE (miss rate).Overall sensitivity was 79% (95% confidence interval [CI], 61 to 90), specificity was 54% (95% CI, 35 to 70), positive predictive value (PPV) was 63% and negative predictive value (NPV) was 71%. Adjusted to significance of findings, sensitivity was 50% (95% CI, 19 to 81), specificity was 76% (95% CI, 63 to 86), PPV was 20% and NPV was 93%.

Conclusion: In comparison to the gold standard, the sensitivity of CCE for detection of relevant polyps is low, however, the high NPV supports its role as a possible screening tool.

Trial registration: NCT00991003.

Figures

Figure 1
Figure 1
Original size of PillCam® Colon Capsule 11 mm × 31 mm
Figure 2
Figure 2
Images of colon polyps on Colonoscopy (left) vs. CCE (right). A: Polyp smaller or as big as 5 mm, B, C: Polyps bigger than 5 mm

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