Capsule Endoscopy Effective and Safe, Research Shows

Second-generation colon capsule endoscopy (CCE-2) appears comparable to traditional colonoscopy in detecting most polyps and adenomas in routine screening of asymptomatic patients for colorectal cancer, according to a recent systematic review and meta-analysis.

Investigators conducted a systematic review of 8 full-text studies to compare colonoscopy and CCE-2 for sensitivity, specificity, and positive and negative likelihood ratios for polyps and adenomas measuring at least 6 mm or 10 mm. These studies included 1602 patients aged 50-75 years.

Of the 840 (52.43%) patients who participated in screening , the authors reported,
“pooled outcomes of CCE-2 for polyps at least 6 mm/10 mm were (CI = confidence interval): sensitivity: 88% (95% CI: 0.84-0.91) / 88% (95% CI: 0.82-0.93), specificity: 94% (95% CI: 0.92-0.95) / 95.5% (95% CI: 0.94-0.97); positive likelihood ratio: 11.86 (95% CI: 5.53-25.46) / 23.07 (95% CI: 6.163-86.36); negative likelihood ratio: 0.14 (95% CI: 0.1-0.21) / 0.14 (95% CI: 0.09-0.21).”

The authors also noted, “The area under the summary receiver operating characteristic curve for polyps at least 6 and 10 mm was 96.3% and 96.7%, respectively. The only cancer CCE-2 missed was shown at multiple frames in the unblinded review. In total, 125 (7.8%) patients presented mild adverse events mostly related to bowel preparation.”

The investigators concluded, “CCE-2 is demonstrated to be an effective and safe alternative method for colorectal cancer screening. Diagnostic performance of CCE-2 for polyps of at least 6 and 10 mm was similar. Completion rates still need to be improved.”

—Rebecca Mashaw

Reference:
Sulbaran M, Bustamante-Lopez L, Bernardo W. Systematic review and meta-analysis of colon capsule endoscopy accuracy for colorectal cancer screening. An alternative during the Covid-19 pandemic? J Med Screen. Published online ahead of print: January 24, 2022. DOI: 10.1177/09691413221074803