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Article: Accuracy of Capsule Colonoscopy in Detecting Colorectal Polyps in a Screening Population

TitleAccuracy of Capsule Colonoscopy in Detecting Colorectal Polyps in a Screening Population
Authors
Issue Date2015
Citation
Gastroenterology, 2015, v. 148, p. 948-957.e2 How to Cite?
AbstractBACKGROUND & AIMS: Capsule colonoscopy is a minimally invasive imaging method. We measured the accuracy of this technology in detecting polyps 6 mm or larger in an average-risk screening population. METHODS: In a prospective study, asymptomatic subjects (n = 884) underwent capsule colonoscopy followed by conventional colonoscopy (the reference) several weeks later, with an endoscopist blinded to capsule results, at 10 centers in the United States and 6 centers in Israel from June 2011 through April 2012. An unblinded colonoscopy was performed on subjects found to have lesions 6 mm or larger by capsule but not conventional colonoscopy. RESULTS: Among the 884 subjects enrolled, 695 (79%) were included in the analysis of capsule performance for all polyps. There were 77 exclusions (9%) for inadequate cleansing and whole-colon capsule transit time fewer than 40 minutes, 45 exclusions (5%) before capsule ingestion, 15 exclusions (2%) after ingestion and before colonoscopy, and 15 exclusions (2%) for site termination. Capsule colonoscopy identified subjects with 1 or more polyps 6 mm or larger with 81% sensitivity (95% confidence interval [CI], 77%-84%) and 93% specificity (95% CI, 91%-95%), and polyps 10 mm or larger with 80% sensitivity (95% CI, 74%-86%) and 97% specificity (95% CI, 96%-98%). Capsule colonoscopy identified subjects with 1 or more conventional adenomas 6 mm or larger with 88% sensitivity (95% CI, 82%-93) and 82% specificity (95% CI, 80%-83%), and 10 mm or larger with 92% sensitivity (95% CI, 82%-97%) and 95% specificity (95% CI, 94%-95%). Sessile serrated polyps and hyperplastic polyps accounted for 26% and 37%, respectively, of false-negative findings from capsule analyses. CONCLUSIONS: In an average-risk screening population, technically adequate capsule colonoscopy identified individuals with 1 or more conventional adenomas 6 mm or larger with 88% sensitivity and 82% specificity. Capsule performance seems adequate for patients who cannot undergo colonoscopy or who had incomplete colonoscopies. Additional studies are needed to improve capsule detection of serrated lesions. Clinicaltrials.gov number: NCT01372878.
Persistent Identifierhttp://hdl.handle.net/10722/209801
ISSN
2015 Impact Factor: 18.187
2015 SCImago Journal Rankings: 7.170
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorRex, DKen_US
dc.contributor.authorAdler, SNen_US
dc.contributor.authorAisenberg, Jen_US
dc.contributor.authorBurch, WCen_US
dc.contributor.authorCarretero, Cen_US
dc.contributor.authorChowers, Yen_US
dc.contributor.authorFein, SAen_US
dc.contributor.authorFern, SEen_US
dc.contributor.authorFernandez-Urien Sainz, Ien_US
dc.contributor.authorFich, Aen_US
dc.contributor.authorGal, Een_US
dc.contributor.authorHorlander Sr, JCen_US
dc.contributor.authorIsaacs, KLen_US
dc.contributor.authorKariv, Ren_US
dc.contributor.authorLahat, Aen_US
dc.contributor.authorLeung, WKen_US
dc.contributor.authorMalik, PRen_US
dc.contributor.authorMorgan, Men_US
dc.contributor.authorPapageorgiou, Nen_US
dc.contributor.authorRomeo, DRen_US
dc.contributor.authorShah, SSen_US
dc.contributor.authorWaterman, Men_US
dc.date.accessioned2015-05-18T03:24:35Z-
dc.date.available2015-05-18T03:24:35Z-
dc.date.issued2015en_US
dc.identifier.citationGastroenterology, 2015, v. 148, p. 948-957.e2en_US
dc.identifier.issn0016-5085-
dc.identifier.urihttp://hdl.handle.net/10722/209801-
dc.description.abstractBACKGROUND & AIMS: Capsule colonoscopy is a minimally invasive imaging method. We measured the accuracy of this technology in detecting polyps 6 mm or larger in an average-risk screening population. METHODS: In a prospective study, asymptomatic subjects (n = 884) underwent capsule colonoscopy followed by conventional colonoscopy (the reference) several weeks later, with an endoscopist blinded to capsule results, at 10 centers in the United States and 6 centers in Israel from June 2011 through April 2012. An unblinded colonoscopy was performed on subjects found to have lesions 6 mm or larger by capsule but not conventional colonoscopy. RESULTS: Among the 884 subjects enrolled, 695 (79%) were included in the analysis of capsule performance for all polyps. There were 77 exclusions (9%) for inadequate cleansing and whole-colon capsule transit time fewer than 40 minutes, 45 exclusions (5%) before capsule ingestion, 15 exclusions (2%) after ingestion and before colonoscopy, and 15 exclusions (2%) for site termination. Capsule colonoscopy identified subjects with 1 or more polyps 6 mm or larger with 81% sensitivity (95% confidence interval [CI], 77%-84%) and 93% specificity (95% CI, 91%-95%), and polyps 10 mm or larger with 80% sensitivity (95% CI, 74%-86%) and 97% specificity (95% CI, 96%-98%). Capsule colonoscopy identified subjects with 1 or more conventional adenomas 6 mm or larger with 88% sensitivity (95% CI, 82%-93) and 82% specificity (95% CI, 80%-83%), and 10 mm or larger with 92% sensitivity (95% CI, 82%-97%) and 95% specificity (95% CI, 94%-95%). Sessile serrated polyps and hyperplastic polyps accounted for 26% and 37%, respectively, of false-negative findings from capsule analyses. CONCLUSIONS: In an average-risk screening population, technically adequate capsule colonoscopy identified individuals with 1 or more conventional adenomas 6 mm or larger with 88% sensitivity and 82% specificity. Capsule performance seems adequate for patients who cannot undergo colonoscopy or who had incomplete colonoscopies. Additional studies are needed to improve capsule detection of serrated lesions. Clinicaltrials.gov number: NCT01372878.en_US
dc.languageengen_US
dc.relation.ispartofGastroenterologyen_US
dc.titleAccuracy of Capsule Colonoscopy in Detecting Colorectal Polyps in a Screening Populationen_US
dc.typeArticleen_US
dc.identifier.emailLeung, WK: waikleung@hku.hken_US
dc.identifier.authorityLeung, WK=rp01479en_US
dc.identifier.doi10.1053/j.gastro.2015.01.025en_US
dc.identifier.pmid25620668-
dc.identifier.scopuseid_2-s2.0-84928600711-
dc.identifier.hkuros243226en_US
dc.identifier.volume148en_US
dc.identifier.spage948en_US
dc.identifier.epage957.e2en_US
dc.identifier.isiWOS:000353335700026-

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