title: Capsule endoscopy versus colonoscopy for the detection of polyps and cancer.
abstract: BACKGROUND
  An ingestible capsule consisting of an endoscope equipped with a video camera at both ends was designed to explore the colon. This study compared capsule endoscopy with optical colonoscopy for the detection of colorectal polyps and cancer.
  
  
  METHODS
  We performed a prospective, multicenter study comparing capsule endoscopy with optical colonoscopy (the standard for comparison) in a cohort of patients with known or suspected colonic disease for the detection of colorectal polyps or cancer. Patients underwent an adapted colon preparation, and colon cleanliness was graded from poor to excellent. We computed the sensitivity and specificity of capsule endoscopy for polyps, advanced adenoma, and cancer.
  
  
  RESULTS
  A total of 328 patients (mean age, 58.6 years) were included in the study. The capsule was excreted within 10 hours after ingestion and before the end of the lifetime of the battery in 92.8% of the patients. The sensitivity and specificity of capsule endoscopy for detecting polyps that were 6 mm in size or bigger were 64% (95% confidence interval [CI], 59 to 72) and 84% (95% CI, 81 to 87), respectively, and for detecting advanced adenoma, the sensitivity and specificity were 73% (95% CI, 61 to 83) and 79% (95% CI, 77 to 81), respectively. Of 19 cancers detected by colonoscopy, 14 were detected by capsule endoscopy (sensitivity, 74%; 95% CI, 52 to 88). For all lesions, the sensitivity of capsule endoscopy was higher in patients with good or excellent colon cleanliness than in those with fair or poor colon cleanliness. Mild-to-moderate adverse events were reported in 26 patients (7.9%) and were mostly related to the colon preparation.
  
  
  CONCLUSIONS
  The use of capsule endoscopy of the colon allows visualization of the colonic mucosa in most patients, but its sensitivity for detecting colonic lesions is low as compared with the use of optical colonoscopy. (ClinicalTrials.gov number, NCT00604162.)
authors: Department of Gastroenterology, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium. andre.vangossum@erasme.ulb.ac.be
authors: André
authors: A
authors: Van Gossum
authors: Miguel
authors: M
authors: Munoz-Navas
authors: Miguel Munoz
authors: MM
authors: Navas
authors: Iñaqui
authors: I
authors: Fernandez-Urien
authors: Cristina
authors: C
authors: Carretero
authors: Gérard
authors: G
authors: Gay
authors: Michel
authors: M
authors: Delvaux
authors: Marie Georges
authors: MG
authors: Lapalus
authors: Thierry
authors: T
authors: Ponchon
authors: Horst
authors: H
authors: Neuhaus
authors: Michael
authors: M
authors: Philipper
authors: Guido
authors: G
authors: Costamagna
authors: Maria Elena
authors: ME
authors: Riccioni
authors: Cristiano
authors: C
authors: Spada
authors: Lucio
authors: L
authors: Petruzziello
authors: Chris
authors: C
authors: Fraser
authors: Aymer
authors: A
authors: Postgate
authors: Aine
authors: A
authors: Fitzpatrick
authors: Friedrich
authors: F
authors: Hagenmuller
authors: Martin
authors: M
authors: Keuchel
authors: Nathalie
authors: N
authors: Schoofs
authors: Jacques
authors: J
authors: Devière
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D053705:Capsule Endoscopes; D053704:Capsule Endoscopy; D003111:Colonic Polyps / Q000175:diagnosis*; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007413:Intestinal Mucosa / Q000033:anatomy & histology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D055815:Young Adult