title: Uptake of Colon Capsule Endoscopy vs Colonoscopy for Screening Relatives of Patients With Colorectal Cancer.
abstract: OBJECTIVE
  The efficacy of screening colonoscopy in first-degree relatives (FDRs) of patients with colorectal cancer (CRC) is limited by suboptimal uptake. We compared screening uptake of colon capsule endoscopy (CCE) vs colonoscopy in this population.
  
  
  METHODS
  We performed a prospective study of 329 asymptomatic FDRs of patients with CRC who were randomly assigned to groups examined by CCE (PillCam, second generation; n = 165) or colonoscopy (n = 164) at a tertiary hospital in Spain from July 2012 through December 2013. Crossover was permitted for patients who did not wish to undergo the assigned procedure. Subjects assigned to CCE who had a significant lesion (polyp ≥ 10 mm, >2 polyps of any size, or CRC) were invited to undergo colonoscopy.
  
  
  RESULTS
  One hundred twenty subjects in the CCE group and 113 in the colonoscopy group were eligible for inclusion. In the intention-to-screen analysis, uptake was similar between groups (55.8% CCE vs 52.2% colonoscopy; odds ratio [OR], 0.86; 95% confidence interval [CI], 0.51-1.44; P = .57); 57.4% of subjects crossed over from the CCE group, and 30.2% crossed over from the colonoscopy group (OR, 3.11; 95% CI, 1.51-6.41; P = .002). Unwillingness to repeat bowel preparation in the case of a positive result was the main reason that subjects assigned to the CCE group crossed over; fear of colonoscopy was the reason that most patients in this group crossed over. A significant lesion was detected in 14 subjects (11.7%) in the CCE group and 13 subjects (11.5%) in the colonoscopy group (OR, 1.02; 95% CI, 0.45-2.26; P = .96).
  
  
  CONCLUSIONS
  In a prospective study, similar numbers of FDRs of patients with CRC assigned to undergo CCE or colonoscopy agreed to participate, but most preferred to undergo colonoscopy. CCE was as effective as colonoscopy in detecting significant lesions; it could be a valid rescue strategy for subjects who reject screening colonoscopy. ClinicalTrials.gov number: NCT01557101.
authors.affiliation: Servicio de Gastroenterología, Hospital Universitario de Canarias; Instituto Universitario de Tecnologías Biomédicas (ITB), Centro de Investigación Biomédica de Canarias (CIBICAN); and Departamento de Medicina Interna, Universidad de La Laguna, Tenerife, Spain.
authors.forename: Zaida
authors.initials: Z
authors.lastname: Adrián-de-Ganzo
authors.affiliation: Servicio de Gastroenterología, Hospital Universitario de Canarias; Instituto Universitario de Tecnologías Biomédicas (ITB), Centro de Investigación Biomédica de Canarias (CIBICAN); and Departamento de Medicina Interna, Universidad de La Laguna, Tenerife, Spain.
authors.forename: Onofre
authors.initials: O
authors.lastname: Alarcón-Fernández
authors.affiliation: Servicio de Gastroenterología, Hospital Universitario de Canarias; Instituto Universitario de Tecnologías Biomédicas (ITB), Centro de Investigación Biomédica de Canarias (CIBICAN); and Departamento de Medicina Interna, Universidad de La Laguna, Tenerife, Spain.
authors.forename: Laura
authors.initials: L
authors.lastname: Ramos
authors.affiliation: Servicio de Gastroenterología, Hospital Universitario de Canarias; Instituto Universitario de Tecnologías Biomédicas (ITB), Centro de Investigación Biomédica de Canarias (CIBICAN); and Departamento de Medicina Interna, Universidad de La Laguna, Tenerife, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Gimeno-García
authors.affiliation: Servicio de Gastroenterología, Hospital Universitario de Canarias; Instituto Universitario de Tecnologías Biomédicas (ITB), Centro de Investigación Biomédica de Canarias (CIBICAN); and Departamento de Medicina Interna, Universidad de La Laguna, Tenerife, Spain.
authors.forename: Inmaculada
authors.initials: I
authors.lastname: Alonso-Abreu
authors.affiliation: Servicio de Gastroenterología, Hospital Universitario de Canarias; Instituto Universitario de Tecnologías Biomédicas (ITB), Centro de Investigación Biomédica de Canarias (CIBICAN); and Departamento de Medicina Interna, Universidad de La Laguna, Tenerife, Spain.
authors.forename: Marta
authors.initials: M
authors.lastname: Carrillo
authors.affiliation: Servicio de Gastroenterología, Hospital Universitario de Canarias; Instituto Universitario de Tecnologías Biomédicas (ITB), Centro de Investigación Biomédica de Canarias (CIBICAN); and Departamento de Medicina Interna, Universidad de La Laguna, Tenerife, Spain. Electronic address: equinter@gmail.com.
authors.forename: Enrique
authors.initials: E
authors.lastname: Quintero
mesh_terms: D000328:Adult; D000368:Aged; D053704:Capsule Endoscopy; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D055088:Early Detection of Cancer / Q000379:methods*; D005190:Family; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013030:Spain
keywords: Colon Cancer; Colon Capsule-2; Detection; Participation; Tumor