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CC BY-NC-ND 4.0 · Endosc Int Open 2021; 09(04): E562-E571
DOI: 10.1055/a-1353-4849
Review

Second-generation colon capsule endoscopy for detection of colorectal polyps: Systematic review and meta-analysis of clinical trials

Tobias Möllers
1   Division of Clinical Epidemiology and Aging Research, German Cancer Research Centre, Heidelberg, Germany
,
Matthias Schwab
2   Dr. Margarete Fischer Bosch Institute of Clinical Pharmacology, Clinical Pharmacogenomics and Cancer, Stuttgart, Germany
3   Department of Clinical Pharmacology, University Hospitals Tubingen, Tubingen, Germany
4   Department of Pharmacy and Biochemistry, University of Tübingen, Tübingen, Germany
5   German Cancer Consortium, Partner Site Tubingen, Tubingen, Germany 
,
Lisa Gildein
6   Department of Gastroenterology and Hepatology, Robert Bosch Hospital, Stuttgart, Germany
,
Michael Hoffmeister
1   Division of Clinical Epidemiology and Aging Research, German Cancer Research Centre, Heidelberg, Germany
,
Jörg Albert
6   Department of Gastroenterology and Hepatology, Robert Bosch Hospital, Stuttgart, Germany
,
Hermann Brenner
1   Division of Clinical Epidemiology and Aging Research, German Cancer Research Centre, Heidelberg, Germany
7   Division of Preventive Oncology, National Center for Tumor Diseases, Heidelberg, Germany
8   German Cancer Consortium, Heidelberg, Germany
,
Simon Jäger
2   Dr. Margarete Fischer Bosch Institute of Clinical Pharmacology, Clinical Pharmacogenomics and Cancer, Stuttgart, Germany
3   Department of Clinical Pharmacology, University Hospitals Tubingen, Tubingen, Germany
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Abstract

Background and study aims Adherence to colorectal cancer (CRC) screening is still unsatisfactory in many countries, thereby limiting prevention of CRC. Colon capsule endoscopy (CCE), a minimally invasive procedure, could be an alternative to fecal immunochemical tests or optical colonoscopy for CRC screening, and might increase adherence in CRC screening. This systematic review and meta-analysis evaluates the diagnostic accuracy of CCE compared to optical colonoscopy (OC) as the gold standard, adequacy of bowel preparation regimes and the patient perspective on diagnostic measures.

Methods We conducted a systematic literature search in PubMed, EMBASE and the Cochrane Register for Clinical Trials. Pooled estimates for sensitivity, specificity and the diagnostic odds ratio with their respective 95 % confidence intervals (CI) were calculated for studies providing sufficient data.

Results Of 840 initially identified studies, 13 were included in the systematic review and up to 9 in the meta-analysis. The pooled sensitivities and specificities for polyps ≥ 6 mm were 87 % (95 % CI: 83 %–90 %) and 87 % (95 % CI: 76 %–93 %) in 8 studies, respectively. For polyps ≥ 10 mm, the pooled estimates for sensitivities and specificities were 87 % (95 % CI: 83 %–90 %) and 95 % (95 % CI: 92 %–97 %) in 9 studies, respectively. A patients’ perspective was assessed in 31 % (n = 4) of studies, and no preference of CCE over OC was reported. Bowel preparation was adequate in 61 % to 92 % of CCE exams.

Conclusions CCE provides high diagnostic accuracy in an adequately cleaned large bowel. Conclusive findings on patient perspectives require further studies to increase acceptance/adherence of CCE for CRC screening.

Supplementary material



Publication History

Received: 07 July 2020

Accepted: 19 October 2020

Article published online:
12 April 2021

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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