Colon capsule endoscopy in colorectal cancer screening: Interim analyses of randomized controlled trial CareForColon2015

Deding, Ulrik; Bjørsum-Meyer, Thomas; Kaalby, Lasse; Kobæk-Larsen, Morten; Thygesen, Marianne Kirstine; Madsen, Jeppe Buur; Krøijer, Rasmus; Baatrup, Gunnar

doi:10.1055/a-1546-8727

Cited by 12 publications

(10 citation statements)

References 18 publications

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“…In particular, less than 50% of the examinations were both complete and with adequate bowel preparation; and the authors concluded that improvement would be needed to increase the reliability of CCE, since most of the missed colonic advanced neoplasia were due to incomplete CCE with distal neoplasia location [ 86 ]. In analogy to this, the previously discussed Danish trial also reported a lower-than-expected completion rate, and discussed ways to optimize that [ 50 ]. In the 2021 meta-analysis by Kjølhede et al, the rate of patients with adequate bowel preparation varied from 40% to 100%, and the rates of complete CCE transit varied from 57% to 100%.…”

Section: Limitations In the Use Of Colon Capsule Endoscopymentioning

confidence: 97%

“…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%

“…The polyp detection rate was 73.5%, and six suspected cancers were identified (2.6%). The authors discussed the satisfactory outcomes, but concluded that the lower-than-expected proportion of suspected cancers would be followed-up, and explored ways to improve the completion rate [ 50 ].…”

Section: The Role Of Colon Capsule Endoscopy In Screening For Advance...mentioning

confidence: 99%

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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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Section: Limitations In the Use Of Colon Capsule Endoscopymentioning

confidence: 97%

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

confidence: 99%

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

et al. 2022

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“… 1–6 In complete CCE investigations, polyp detection rates (PDR) for large polyps and complications appear to be equivalent or better than those reported from conventional optical colonoscopy. 1 , 7 , 8 One of the drawbacks in CCE is the high proportion of incomplete examinations 9 leading to patients needing additional investigations. Incomplete CCE investigations can be caused by inadequate bowel cleansing or a transit time exceeding the battery lifetime.…”

Section: Introductionmentioning

confidence: 99%

“… 10 The interim analysis from this trial was published in the summer of 2021, revealing a CCE completion rate of 67.9%, which was lower than expected. 7 This elicited an examination of how to improve the completion rate by adjusting the bowel preparation regimen. 10 Adding prucalopride (Resolor ® ) to the regimen prior to capsule ingestion seemed a logical adjustment.…”

Section: Introductionmentioning

confidence: 99%

The Effect of Prucalopride on the Completion Rate and Polyp Detection Rate of Colon Capsule Endoscopies

Deding¹,

Kaalby²,

Baatrup³

et al. 2022

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Purpose To investigate whether the prokinetic prucalopride increases the completion rate of colon capsule endoscopy (CCE). Secondary outcomes included demographic distribution, polyp detection rate (PDR), distribution of Leighton–Rex grade, and adverse events. Patients and Methods In a nested cohort within the CareForColon2015 trial, a subgroup of 406 individuals underwent CCE in 2021. The first half (control) received the standard bowel preparation and the second half (prucalopride) was supplemented with 2 mg of prucalopride. Transit times and bowel preparations were analyzed and completion rates calculated as those having timely transit and acceptable bowel cleanliness. Major adverse events were recorded continuously and minor adverse events were quantified from questionnaires. Results The group demographics were homogenous. The prevalence ratio for complete CCE was 1.32 (CI 95% 1.15; 1.53) in the prucalopride group compared to the control group. Completion rate was 74.9% in the prucalopride group and 56.7% in the control group. The proportions of acceptable bowel preparation and complete transits were higher in the prucalopride group. The mean CCE transit time was 2 hours and 8 minutes faster in the prucalopride group. The PDR was higher in the intervention group with 55.7% compared to 36.0% in the control group for polyps greater than 9 mm, whereas the groups’ PDRs were similar for small and diminutive polyps. In all, 589 polyps (mean 2.9) were found in the prucalopride group compared to 522 polyps (mean 2.6) in the control group. Conclusion Prucalopride led to an increase in CCE completion rates. The proportions of complete transits and acceptable bowel preparations were higher in the prucalopride group. The PDR was higher in the prucalopride group compared to the control group. No major adverse events were identified. Nausea, diarrhea, headache and fatigue were more commonly reported in the prucalopride group.

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Interobserver agreement on landmark and flexure identification in colon capsule endoscopy

et al. 2023

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Purpose When an optical colonoscopy is carried out, Scope Guide can assist the endoscopist in determining the localization. In colon capsule endoscopy (CCE), this support is not available. To our knowledge, the interobserver agreement on landmark identification has never been studied. This study aims to investigate the interobserver agreement on landmark identification in CCE. Methods An interobserver study was carried out comparing the landmark identification (the ileocecal valve, hepatic flexure, splenic flexure, and anus) in CCE investigations between an external private contractor and three in-house CCE readers with different levels of experience. All CCE investigations analyzed in this study were carried out as a part of the Danish screening program for colorectal cancer. Patients were between 50 and 74 years old with a positive fecal immunochemical test (FIT). A random sample of 20 CCE investigations was taken from the total sample of more than 800 videos. Results Overall interobserver agreement on all landmarks was 51%. Interobserver agreement on the first cecal image (ileocecal valve), hepatic flexure, splenic flexure, and last rectal image (anus) was 72%, 29%, 22%, and 83%, respectively. The overall interobserver agreement, including only examinations with adequate bowel preparation (n = 16), was 54%, and for individual landmarks, 73%, 32%, 24%, and 85%. Conclusion Overall interobserver agreement on all four landmarks from CCE was poor. Measures are needed to improve landmark identification in CCE investigations. Artificial intelligence could be a possible solution to this problem.

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Colon capsule endoscopy in colorectal cancer screening: Interim analyses of randomized controlled trial CareForColon2015

Cited by 12 publications

References 18 publications

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

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

The Effect of Prucalopride on the Completion Rate and Polyp Detection Rate of Colon Capsule Endoscopies

Interobserver agreement on landmark and flexure identification in colon capsule endoscopy

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