Colon Capsule Endoscopy compared to Conventional Colonoscopy under routine screening conditions

• Published in: BMC gastroenterology 2010-06, Vol.10 (1), p.66-66, Article 66
• Main Authors: Pilz, Julia B, Portmann, Susanne, Peter, Shajan, Beglinger, Christoph, Degen, Lukas
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Capsule Endoscopy - methods; Cathartics; Colon; Colonic Polyps - diagnosis; Colonic Polyps - pathology; Colonoscopy; Colonoscopy - methods; Colorectal cancer; Colorectal Neoplasms - diagnosis; Colorectal Neoplasms - pathology; Comparative analysis; Data collection; Design; Diagnosis; Endoscopy; Family medical history; Feasibility studies; Female; Gastroenterology; Hepatology; Hospitals; Humans; Male; Mass Screening - methods; Medical screening; Middle Aged; Motility; Patient Acceptance of Health Care; Pilot Projects; Prospective Studies; Retrospective Studies; Sensitivity and Specificity; Statistical analysis
• ISSN: 1471-230X; 1471-230X
• DOI: 10.1186/1471-230x-10-66

Colonoscopy (CSPY) for colorectal cancer screening has several limitations. Colon Capsule Endoscopy (PillCam Colon, CCE) was compared to CSPY under routine screening conditions. 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. 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%. 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. NCT00991003.