Colon capsule endoscopy vs. colonoscopy in patients at average or increased risk of colorectal cancer
S Sacher-Huvelin, E Coron, M Gaudric, L Planche, R Benamouzig, V Maunoury, B Filoche, M Frédéric, J-C Saurin, C Subtil, S Lecleire, C Cellier, D Coumaros, D Heresbach, J P Galmiche, S Sacher-Huvelin, E Coron, M Gaudric, L Planche, R Benamouzig, V Maunoury, B Filoche, M Frédéric, J-C Saurin, C Subtil, S Lecleire, C Cellier, D Coumaros, D Heresbach, J P Galmiche
Abstract
Background: Colon capsule endoscopy (CCE) is a new, non-invasive technology.
Aim: To conduct a prospective, multicentre trial to compare CCE and colonoscopy in asymptomatic subjects enrolled in screening or surveillance programmes for the detection of colorectal neoplasia.
Methods: Patients underwent CCE on day one and colonoscopy (gold standard) on day two. CCE and colonoscopy were performed by independent endoscopists.
Results: A total of 545 patients were recruited. CCE was safe and well-tolerated. Colon cleanliness was excellent or good in 52% of cases at CCE. Five patients with cancer were detected by colonoscopy, of whom two were missed by CCE. CCE accuracy for the detection of polyps ≥ 6 mm was 39% (95% CI 30-48) for sensitivity, 88% (95% CI 85-91) for specificity, 47% (95% CI 37-57) for positive predictive value and 85% (95% CI 82-88) for negative predictive value. CCE accuracy was better for the detection of advanced adenoma, in patients with good or excellent cleanliness and after re-interpretation of the CCE videos by an independent expert panel.
Conclusions: Although well-tolerated, CCE cannot replace colonoscopy as a first line investigation for screening and surveillance of patients at risk of cancer. Further studies should pay attention to colonic preparation (Clinicaltrial.gov number NCT00436514).
© 2010 Blackwell Publishing Ltd.
Source: PubMed