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DOI: 10.1055/a-2438-7223
Non-neoplastic findings in colon capsule endoscopy: Additional yield
Abstract
Background and study aims Despite the common occurrence of non-neoplastic findings (NNFs) in individuals with a positive fecal immunochemical test (FIT), few studies have reported on these findings. The aim of this cross-sectional study was to determine the prevalence of colonic NNFs in three cohorts of Danish clinical trial participants who underwent colon capsule endoscopy (CCE).
Patients and methods Retrospectively collecting NNFs from CCE reports of three Danish trials, we classified them into five categories: diverticula, vascular abnormalities, inflammation, erosions/ulcerations, and others. The statistical analysis included 516 participants from three trials, with a mean age ranging from 59.2 to 63.9 years. The participants in the three trials were FIT-positive screening or symptomatic individuals.
Results NNFs were reported in more than half of the CCE procedures (50.6% to 77.9%), with colonic diverticula being the most common NNF appearing in 40.9% to 66.9% of the CCE reports. Vascular abnormalities and erosions/ulcerations were also common depending on the specific trial.
Conclusions NNFs are common and may be an indicator of more widespread disease. Furthermore, NNFs may develop into clinically significant conditions despite their benign appearance. This paper expands on the limited literature about prevalence of NNFs and underscores the additional value of CCE video recordings beyond detecting polyps.
Keywords
Endoscopy Lower GI Tract - Polyps / adenomas / ... - CRC screening - Diagnosis and imaging (inc chromoendoscopy, NBI, iSCAN, FICE, CLE...) - Lower GI bleedingPublication History
Received: 30 April 2024
Accepted after revision: 09 September 2024
Article published online:
07 November 2024
© 2024. 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/).
Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany
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References
- 1 Spada C, De Vincentis F, Cesaro P. et al. Accuracy and safety of second-generation PillCam COLON capsule for colorectal polyp detection. Therap Adv Gastroenterol 2012; 5: 173-178 DOI: 10.1177/1756283X12438054. (PMID: 22570677)
- 2 MacLeod C, Hudson J, Brogan M. et al. ScotCap - A large observational cohort study. Colorectal Dis 2022; 24: 411-421 DOI: 10.1111/codi.16029. (PMID: 34935278)
- 3 NHS England. NHS rolls out capsule cameras to test for cancer. Leeds: National Health Service. 2021 Accessed March 11, 2024 at: https://www.england.nhs.uk/2021/03/nhs-rolls-out-capsule-cameras-to-test-for-cancer/
- 4 Vuik FER, Nieuwenburg SAV, Moen S. et al. Population-based prevalence of gastrointestinal abnormalities at colon capsule endoscopy. Clin Gastroenterol Hepatol 2022; 20: 692-700.e7
- 5 Bevan R, Lee TJ, Nickerson C. et al. Non-neoplastic findings at colonoscopy after positive faecal occult blood testing: data from the English Bowel Cancer Screening Programme. J Med Screen 2014; 21: 89-94
- 6 Kobaek-Larsen M, Kroijer R, Dyrvig AK. et al. Back-to-back colon capsule endoscopy and optical colonoscopy in colorectal cancer screening individuals. Colorectal Dis 2018; 20: 479-485 DOI: 10.1111/codi.13965. (PMID: 29166546)
- 7 Deding U, Herp J, Havshoei AL. et al. Colon capsule endoscopy versus CT colonography after incomplete colonoscopy. Application of artificial intelligence algorithms to identify complete colonic investigations. United European Gastroenterol J 2020; 8: 782-789 DOI: 10.1177/2050640620937593. (PMID: 32731841)
- 8 Kroijer R, Dyrvig AK, Kobaek-Larsen M. et al. Booster medication to achieve capsule excretion in colon capsule endoscopy: a randomized controlled trial of three regimens. Endosc Int Open 2018; 6: E1363-e8 DOI: 10.1055/a-0732-494. (PMID: 30410958)
- 9 von Elm E, Altman DG, Egger M. et al. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. J Clin Epidemiol 2008; 61: 344-349 DOI: 10.1016/j.jclinepi.2007.11.008. (PMID: 18313558)
- 10 StataCorp. Stata Statistical Software: Release 17. College Station. TX: StataCorp LLC; 2021. DOI: 10.1016/j.plabm.2024.e00418 (PMID: 39119471)
- 11 Ciatto S, Martinelli F, Castiglione G. et al. Association of FOBT-assessed faecal Hb content with colonic lesions detected in the Florence screening programme. Br J Cancer 2007; 96: 218-221
- 12 Ozaki T, Tokunaga A, Chihara N. et al. Total colonoscopy detects early colorectal cancer more frequently than advanced colorectal cancer in patients with fecal occult blood. J Nippon Med Sch 2010; 77: 195-203
- 13 Rajasekhar PT, Clifford GM, Lee TJW. et al. Bowel cancer screening is safe, detects earlier stage cancer and adenomas in 50% of cases: experience of the prevalent round of screening from two first wave centres in the North East of England. Frontline Gastroenterol 2012; 3: 10-15
- 14 Ismail MS, Semenov S, Sihag S. et al. Colon capsule endoscopy is a viable alternative to colonoscopy for the investigation of intermediate- and low-risk patients with gastrointestinal symptoms: results of a pilot study. Endosc Int Open 2021; 9: E965-e70
- 15 Adler SN, González Lama Y, Matallana Royo V. et al. Comparison of small-bowel colon capsule endoscopy system to conventional colonoscopy for the evaluation of ulcerative colitis activity. Endosc Int Open 2019; 7: E1253-e61
- 16 Hosoe N, Hayashi Y, Ogata H. colon capsule endoscopy for inflammatory bowel disease. Clin Endosc 2020; 53: 550-554 DOI: 10.5946/ce.2019.156. (PMID: 31914721)
- 17 Peery AF, Keku TO, Martin CF. et al. Distribution and Characteristics of Colonic Diverticula in a United States Screening Population. Clin Gastroenterol Hepatol 2016; 14: 980-985.e1
- 18 Manousos ON, Truelove SC, Lumsden K. Prevalence of colonic diverticulosis in general population of Oxford area. Br Med J 1967; 3: 762-763 DOI: 10.1136/bmj.3.5568.762. (PMID: 6039646)
- 19 Painter NS, Burkitt DP. Diverticular disease of the colon: a deficiency disease of Western civilization. Br Med J 1971; 2: 450-454 DOI: 10.1136/bmj.2.5759.450. (PMID: 4930390)
- 20 Foutch PG, Rex DK, Lieberman DA. Prevalence and natural history of colonic angiodysplasia among healthy asymptomatic people. Am J Gastroenterol 1995; 90: 564-567 (PMID: 7717311)
- 21 Boley SJ, Sammartano R, Adams A. et al. On the nature and etiology of vascular ectasias of the colon. Degenerative lesions of aging. Gastroenterology 1977; 72: 650-660 (PMID: 300063)
- 22 Heer M, Sulser H, Hany A. Angiodysplasia of the colon: an expression of occlusive vascular disease. Hepatogastroenterology 1987; 34: 127-131 (PMID: 2440788)
- 23 Wilcox CM, Clark WS. Causes and outcome of upper and lower gastrointestinal bleeding: the Grady Hospital experience. South Med J 1999; 92: 44-50 DOI: 10.1097/00007611-199901000-00008. (PMID: 9932826)
- 24 Duray PH, Marcal JM, LiVolsi VA. et al. Small intestinal angiodysplasia in the elderly. J Clin Gastroenterol 1984; 6: 311-319 DOI: 10.1097/00004836-198408000-00001. (PMID: 6332839)
- 25 Halder W, Laskaratos FM, El-Mileik H. et al. Review: Colon capsule endoscopy in inflammatory bowel disease. Diagnostics (Basel) 2022; 12: 149 DOI: 10.3390/diagnostics12010149. (PMID: 35054315)
- 26 Bjoersum-Meyer T, Skonieczna-Zydecka K, Cortegoso Valdivia P. et al. Efficacy of bowel preparation regimens for colon capsule endoscopy: a systematic review and meta-analysis. Endosc Int Open 2021; 9: E1658-e73
- 27 Spada C, Hassan C, Galmiche JP. et al. Colon capsule endoscopy: European Society of Gastrointestinal Endoscopy (ESGE) Guideline. Endoscopy 2012; 44: 527-536 DOI: 10.1055/s-0031-1291717. (PMID: 22389230)
- 28 Murphy B, Myers E, O'Shea T. et al. Correlation between adenoma detection rate and polyp detection rate at endoscopy in a non-screening population. Sci Rep 2020; 10: 2295
- 29 Boroff ES, Disbrow M, Crowell MD. et al. Adenoma and polyp detection rates in colonoscopy according to indication. Gastroenterol Res Pract 2017; 2017: 7207595 DOI: 10.1155/2017/7207595. (PMID: 29445393)
- 30 Cooper GS, Chak A, Koroukian S. The polyp detection rate of colonoscopy: a national study of Medicare beneficiaries. Am J Med 2005; 118: 1413 DOI: 10.1016/j.amjmed.2005.06.019. (PMID: 16378787)
- 31 Vuik FER, Nieuwenburg SAV, Moen S. et al. Colon capsule endoscopy in colorectal cancer screening: a systematic review. Endoscopy 2021; 53: 815-824 DOI: 10.1055/a-1308-1297. (PMID: 33440442)
- 32 Chalasani N, Cotsonis G, Wilcox CM. Upper gastrointestinal bleeding in patients with chronic renal failure: role of vascular ectasia. Am J Gastroenterol 1996; 91: 2329-2332 (PMID: 8931412)
- 33 Shahedi K, Fuller G, Bolus R. et al. Long-term risk of acute diverticulitis among patients with incidental diverticulosis found during colonoscopy. Clin Gastroenterol Hepatol 2013; 11: 1609-1613
- 34 Cappell MS, Lebwohl O. Cessation of recurrent bleeding from gastrointestinal angiodysplasias after aortic valve replacement. Ann Intern Med 1986; 105: 54-57 DOI: 10.7326/0003-4819-105-1-54. (PMID: 3487267)
- 35 Scheffer SM, Leatherman LL. Resolution of Heyde's syndrome of aortic stenosis and gastrointestinal bleeding after aortic valve replacement. Ann Thorac Surg 1986; 42: 477-480 DOI: 10.1016/s0003-4975(10)60563-2. (PMID: 3490235)
- 36 Losanoff JE, Richman BW, Foerst JR. et al. Nonspecific ulcers of the colon. Endoscopy 2003; 35: 521-525 DOI: 10.1055/s-2003-39663. (PMID: 12783352)
- 37 Nagar AB. Isolated colonic ulcers: diagnosis and management. Curr Gastroenterol Rep 2007; 9: 422-428 DOI: 10.1007/s11894-007-0053-9. (PMID: 17991345)
- 38 Barnett KN, Clark GRC, Steele RJC. et al. Faecal haemoglobin estimated by faecal immunochemical tests-an indicator of systemic inflammation with real clinical potential. Diagnostics (Basel) 2021; 11: 2093