A meta-analysis evaluating the accuracy of colon capsule endoscopy in detecting colon polyps

• Published in: Gastrointestinal endoscopy 2010-04, Vol.71 (4), p.792-798
• Main Authors: Rokkas, Theodore, MD, PhD, Papaxoinis, Konstantinos, MD, Triantafyllou, Konstantinos, MD, Ladas, Spiros D., MD
• Format: Article
• Language: English
• Subjects: Biological and medical sciences; Capsule Endoscopy - standards; Colonic Polyps - diagnosis; Digestive system. Abdomen; Endoscopy; Endoscopy, Gastrointestinal; Gastroenterology and Hepatology; Gastroenterology. Liver. Pancreas. Abdomen; Humans; Investigative techniques, diagnostic techniques (general aspects); Medical sciences; Sensitivity and Specificity; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; Tumors
• ISSN: 0016-5107; 1097-6779
• DOI: 10.1016/j.gie.2009.10.050

Background Colon capsule endoscopy (CCE) is a new, noninvasive method for examining the entire colon. The reported yield of CCE in detecting colorectal polyps has shown variable results. Objective To assess the accuracy of CCE by pooling data of existing trials. Design Meta-analysis. The fixed-effects or random-effects model was used as appropriate, based on whether homogeneity or heterogeneity, respectively, was indicated by the Cochran Q test. Setting Studies that estimated the accuracy of CCE were identified. Two investigators independently conducted the search and data extraction. Patients A total of 626 individuals were included in this meta-analysis. Intervention Each patient underwent CCE and conventional colonoscopy. Main Outcome Measurements Per-patient sensitivity and specificity, with 95% confidence intervals (CI). Results Findings were categorized as “significant polyps,” that is, a report of a polyp >6 mm in size or 3 or more polyps of any size, or “any polyp,” that is, a report of any polyp found, independent of size. Pooled data on sensitivity and specificity with a 95% CI were estimated. For any polyp found, the pooled data showed per-patient CCE sensitivity of 73% (95% CI, 68%-77%) and specificity of 89% (95% CI, 81%-94%). For significant polyps, the respective values were 69% (95% CI, 62%-75%) and 86% (95% CI, 82%-90%). Limitations A small number of studies met inclusion criteria. Conclusion CCE is a reasonable method for screening asymptomatic individuals for colorectal polyps. It may be particularly useful for patients with “incomplete” colonoscopy, those with contraindications for conventional colonoscopy, and those unwilling to undergo colonoscopy because of its perceived inconvenience and discomfort.