Accuracy of Capsule Colonoscopy in Detecting Colorectal Polyps in a Screening Population (original) (raw)
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Gastrointestinal Endoscopy, 2014
diagnostic utility and patient acceptability of CCE2. Patients and Methods: CCE2 procedure was performed in patients with significant colonic lesions requiring endoscopic or surgical treatment as determined by diagnostic optical colonoscopy (OC) performed within 3 months prior to the procedure. Significant lesion was defined as polyp of R 6 mm or of any size which requires a treatment as determined by the physician. The primary endpoint was the sensitivity of CCE2 compared with OC in detecting patients with significant lesions. Sensitivity of R 85% was defined as "clinically effective". The secondary endpoints were per-lesion analysis and detection, acceptability of CCE2 for patients, colon cleansing level, capsule excretion rate, and adverse events. The recorded capsule videos were reviewed by both investigators and independent central readers. Results: Seventy-two patients were enrolled between December 2011 and May 2012. Six patients were excluded from the analysis because of withdrawal due to personal reasons (4 cases), noncompliance with the procedure (1 case), and technical failure of CCE2 (1 case). In the 66 cases (Male 51 cases, 59.7AE10.2 years old), the sensitivity of the CCE2 in detecting patients with significant lesion is 94 % (95%CI, 88.2-99.7). The CCE2 detected 247 polyps of any size compared with 167 polyps detected by the OC (significant difference, Z-test: pZ0.0232). Of the polyps R 6 mm, the CCE2 detected 158 polyps vs. 99 polyps detected by the OC (significant difference, Z-test: pZ0.0232), and of the polyps R 10 mm, the CCE2 detected 76 polyps vs. 63 polyps detected by the OC (no significance, Z-test: pZ0.327). For evaluation of patient acceptability to the CCE2 procedure, the ratio of the patients who answered "not at all" and "almost not" for "embarrassment", "fear", and "pain" are 96% (63 cases), 83% (55 cases), 99% (65 cases), respectively. In addition, 58 patients (88%) reported that CCE2 ingestion was "very easy" or "easy". In 62 of 66 patients (94%), the cleansing level of the colon is adequate. In the 58 of 66 cases (88%), CCE2 was excreted within its operating time. no severe adverse events were reported. In one case (1.5%), mild vomiting occurred during the procedure. Conclusion: CCE2 is a safe and clinically effective tool for detecting significant colonic lesions with high accuracy and high patient acceptability.
Endoscopy, 2020
Background Colon capsule endoscopy (CCE) is a technology that might contribute to colorectal cancer (CRC) screening programs as a filter test between fecal immunochemical testing and standard colonoscopy. The aim was to systematically review the literature for studies investigating the diagnostic yield of second-generation CCE compared with standard colonoscopy. Methods A systematic literature search was performed in PubMed, Embase, and Web of Science. Study characteristics including quality of bowel preparation and completeness of CCE transits were extracted. Per-patient sensitivity and specificity were extracted for polyps (any size, ≥ 10 mm, ≥ 6 mm) and lesion characteristics. Meta-analyses of diagnostic yield were performed. Results The literature search revealed 1077 unique papers and 12 studies were included. Studies involved a total of 2199 patients, of whom 1898 were included in analyses. The rate of patients with adequate bowel preparation varied from 40 % to 100 %. The rat...
Gastroenterology, 2003
This study used a low lesion prevalence population reflective of the screening setting to estimate the sensitivity and specificity of computerized tomographic (CT) colonography for detection of colorectal polyps. Methods: This prospective, blinded study comprised 703 asymptomatic persons at higher-thanaverage risk for colorectal cancer who underwent CT colonography followed by same-day colonoscopy. Two of 3 experienced readers interpreted each CT colonography examination. Results: Overall lesion prevalence for adenomas >1 cm in diameter was 5%. Seventy percent of all lesions were proximal to the descending colon. With colonoscopy serving as the gold standard, CT colonography detected 34%, 32%, 73%, and 63% of the 59 polyps >1 cm for readers 1, 2, 3, and double-reading, respectively; and 35%, 29%, 57%, and 54% of the 94 polyps 5-9 mm for readers 1, 2, 3, and double-reading, respectively. Specificity for CT colonography ranged from 95% to 98% and 86% to 95% for >1 cm and 5-9-mm polyps, respectively. Interobserver variability was high for CT colonography with statistic values ranging from ؊0.67 to 0.89. Conclusions: In a low prevalence setting, polyp detection rates at CT colonography are well below those at colonoscopy. These rates are less than previous reports based largely on high lesion prevalence cohorts. High interobserver variability warrants further investigation but may be due to the low prevalence of polyps in this cohort and the high impact on total sensitivity of each missed polyp. Specificity, based on large numbers, is high and exhibits excellent agreement among observers.
Second-generation colon capsule endoscopy for detection of colorectal polyps: A meta-analysis
Medical Journal of The Islamic Republic of Iran, 2020
Background: Colorectal cancer counts as the third prevalent type of cancer and the fourth cause of death worldwide. The secondgeneration colon capsule endoscopy (CCE-2) is a new technology for the diagnosis of colon cancer. The aim of this review was to provide information on the diagnostic accuracy (diagnostic effectiveness) of the second-generation colon capsule endoscopy compared to colonoscopy for the diagnosis of colon cancer and disorders. Methods: A systematic review of literature in PubMed, Scopus, Science Direct, and Cochrane Library and Iranian databases, such as MagIran, SID, Irandoc, the grey literature (via Google Scholar) was conducted on February 30, 2018. QUADAS-2 was used to assess the quality of the studies. MetaDiSc 2.0 software was used for the meta-analysis. Results: In this review, 480 records were identified. Eight prospective cohort articles were included among which 7 included in the meta-analysis. For the diagnosis of colorectal polyps with a diameter of 6-10 mm, the pooled sensitivity and specificity were 84% (95% CI, 80%-88%) and 88% (95%CI, 85%-90%). For the diagnosis of 10 mm or bigger colorectal polyps, the pooled sensitivity and specificity were 84% (95% CI, 76%-89%) and 96% (95% CI, 94 %-97%). The sensitivity and specificity of the capsule in the detection of any size polyps were 93% (95% CI, 97%-84%) and 66% (95% CI, 48%-81%), respectively. Conclusion: There is little evidence to show the accuracy of CCE-2. Nevertheless, this review showed that the second-generation colon capsule endoscopy has good accuracy in the detection of polyps and colorectal cancer among high-and middle-risk patients.
Adenoma and Polyp Detection Rates in Colonoscopy according to Indication
Gastroenterology research and practice, 2017
Adenoma detection rate (ADR) is a validated quality measure for screening colonoscopy, but there are little data for other indications. The distribution of adenomas is not well described for these indications. To describe ADR and the adenoma distribution in the proximal and distal colon based on colonoscopy indication. Outpatient colonoscopies are subdivided by indication. PDR and ADR for the entire colon and for proximal and distal colon. Data were compared using generalized estimating equations to adjust for clustering amongst endoscopists while controlling for patient age and gender. 3436 colonoscopies were reviewed (51.2%: men (= 1759)). Indications are screening 49.2%, surveillance 29.3%, change in bowel habit 8.4%, bleeding 5.8%, colitides 3.0%, pain 2.8%, and miscellaneous 1.5%. Overall ADR was 37% proximal ADR 28%, and distal ADR 17%. PDR and ADR were significantly higher in surveillance than in screening (PDR: 69% versus 51%; ADR: 50% versus 33%;= 0.0001). Adenomas were mor...
Gastroenterology Research and Practice, 2019
Backround. Capsule colonoscopy might present an alternative to colonoscopy for colorectal neoplasia screening. Aim. To assess the accuracy of second-generation capsule colonoscopy (CCE2) for colorectal neoplasia detection compared with conventional colonoscopy (CC). Methods. From 2011–2015, we performed a multicenter, prospective, cross-over study evaluating the use of CCE2 as a possible colorectal cancer (CRC) screening test based on the assessment of the method’s characteristics (accuracy) and safety and patient acceptance of the routine. Enrolled participants fulfilled the CRC screening population criteria if they were asymptomatic, were older than 50, and had no personal or familial history of colorectal neoplasia. The primary outcome was accuracy for the detection of polyps≥6 mm. Secondary outcomes were accuracy for all polyps, polyps≥10 mm, adenomas≥10 mm, and cancers, the quality of bowel cleansing, safety, and CCE2 acceptability by the screening population. Results. A total ...