Capsule colonoscopy increases uptake of colorectal cancer screening.
BACKGROUND
Screening colonoscopy effectiveness is hampered by limited adherence by the general population. The present prospective study was performed to evaluate whether adding capsule colonoscopy to the endoscopic screening options increases uptake.


METHODS
Invitation letters were sent to 2150 persons above the age of 55 insured with a German medical insurance company in the area of Rinteln, Lower Saxony with a baseline spontaneous annual screening colonoscopy uptake of 1 %. Both capsule or conventional colonoscopy were offered. Interested persons were given information about the two screening options by four local gastroenterologists and examinations were then performed according to screenees' final choice.


RESULTS
154 persons sought further information, and 34 and 90 underwent conventional and capsule colonoscopy, respectively. Colonoscopy uptake was thus increased by the invitation process by 60 % (1.6 % vs. 1 %; p = 0.075), while the option of capsule endoscopy led to a fourfold increase of screening uptake (4.2 % vs. 1 %, p < 0.001). Despite similar age distribution in both sex groups, uptake in men was significantly higher (5.6 % vs. 2.8 %, p = 002). However, overall adenoma yield was not different in both groups.


CONCLUSIONS
The present study suggests that offering the option of capsule colonoscopy increases uptake of endoscopic colorectal cancer screening. However, capsule endoscopy sensitivity for adenoma detection needs to be improved.
Department of Interdisciplinary Endoscopy, University Hospital Hamburg-Eppendorf, Regional Hospital, Hamburg, Germany. t.roesch@uke.de
Stefan
S
Groth
Horst
H
Krause
Rainer
R
Behrendt
Helge
H
Hill
Michael
M
Börner
Murat
M
Bastürk
Nora
N
Plathner
Friedrich
F
Schütte
Ulrich
U
Gauger
Jürgen Ferdinand
JF
Riemann
Lutz
L
Altenhofen
Thomas
T
Rösch
D000236:Adenoma / Q000175:diagnosis* / Q000453:epidemiology; D000368:Aged; D053704:Capsule Endoscopy / Q000379:methods*; D003113:Colonoscopy / Q000379:methods*; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000453:epidemiology; D003256:Community Participation / Q000706:statistics & numerical data*; D055088:Early Detection of Cancer / Q000379:methods*; D005260:Female; D005858:Germany; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires