Success of colon capsule endoscopy (PillCam Colon 2) in preventing invasive colonoscopy for moderate-risk patients referred on a two-week wait cancer pathway: Our initial experience

ABSTRACT

Introduction: Colon Capsule Endoscopy (CCE) is a painless, minimally invasive camera in a capsule (PillCam Colon 2) that can be swallowed to examine the colon with reliable accuracy. Because of the risk of COVID -19 transmission, renewed interest in CCE has emerged. However, concerns remain about the subsequent need for invasive colonoscopy. Method(s) Our Trust is one of the 42 centers taking part in this NHS-England sponsored pilot study. Patients with moderate risk of colon cancer returning a fecal immunochemical test (FIT) value of 10 to 100 mug/g and willing to participate will be included in the study. Bowel preparation is standardized as per the study guidelines. Our initial experience includes data from 52 patients recruited over the past 6 months. Result(s) There were 52 patients who consented for the study (16 males and 36 females) with mean age of 60 (24-80) years. Complete CCE, with capsule elimination during recording, was achieved in 38 (73%) patients. Fourteen (27%) patients had an incomplete examination, of which 7 (13.5%) patients underwent colonoscopy, 4 of whom needed colonoscopy anyway due to the presence of polyps and IBD. The remaining 7 (13.5%) required only flexible sigmoidoscopy.Of those who underwent a full CCE, 13 (25%) needed colonoscopy and 2 (4%) needed flexible sigmoidoscopy only, due to findings noted on CCE. Thus, altogether CCE avoided colonoscopy in 32 (62%) patients. Conclusion(s) Colon capsule endoscopy reduces the need for invasive colonoscopy. It is a safe, reliable, and noninvasive diagnostic tool.