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DOI: 10.1055/a-1249-3938
Diagnostic accuracy of capsule endoscopy compared with colonoscopy for polyp detection: systematic review and meta-analyses
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Abstract
Background Colon capsule endoscopy (CCE) is a technology that might contribute to colorectal cancer (CRC) screening programs as a filter test between fecal immunochemical testing and standard colonoscopy. The aim was to systematically review the literature for studies investigating the diagnostic yield of second-generation CCE compared with standard colonoscopy.
Methods A systematic literature search was performed in PubMed, Embase, and Web of Science. Study characteristics including quality of bowel preparation and completeness of CCE transits were extracted. Per-patient sensitivity and specificity were extracted for polyps (any size, ≥ 10 mm, ≥ 6 mm) and lesion characteristics. Meta-analyses of diagnostic yield were performed.
Results The literature search revealed 1077 unique papers and 12 studies were included. Studies involved a total of 2199 patients, of whom 1898 were included in analyses. The rate of patients with adequate bowel preparation varied from 40 % to 100 %. The rates of complete CCE transit varied from 57 % to 100 %. Our meta-analyses demonstrated that mean (95 % confidence interval) sensitivity, specificity, and diagnostic odds ratio were: 0.85 (0.73–0.92), 0.85 (0.70–0.93), and 30.5 (16.2–57.2), respectively, for polyps of any size; 0.87 (0.82–0.90), 0.95 (0.92–0.97), and 136.0 (70.6–262.1), respectively, for polyps ≥ 10 mm; and 0.87 (0.83–0.90), 0.88 (0.75–0.95), and 51.1 (19.8–131.8), respectively, for polyps ≥ 6 mm. No serious adverse events were reported for CCE.
Conclusion CCE had high sensitivity and specificity for per-patient polyps compared with standard colonoscopy However, the relatively high rate of incomplete investigations limits the application of CCE in a CRC screening setting.
Publikationsverlauf
Eingereicht: 12. Dezember 2019
Angenommen: 28. August 2020
Accepted Manuscript online:
28. August 2020
Artikel online veröffentlicht:
06. Oktober 2020
© 2020. Thieme. All rights reserved.
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References
- 1 Davila RE, Rajan E, Baron TH. et al. ASGE guideline: colorectal cancer screening and surveillance. Gastrointest Endosc 2006; 63: 546-557
- 2 Sundhedsstyrelsen, Anbefalinger vedrørende screening for tyk- & endetarmskræft. Sundhedsstyrelsen. 2012 Available at (Accessed 11 September 2020): https://www.sst.dk/-/media/Udgivelser/2012/Publ2012/Anbefalninger-vedr%C3%B8rende-screening-for-tyk--og-endetarmskr%C3%A6ft.ashx
- 3 Årsrapport 2017. Danish CRC-screening Database; 2018 Available at (Accessed 11 September 2020): https://dccg.dk/wp-content/uploads/2019/03/DCCG-%C3%85rsrapport-2017v2.pdf
- 4 Thygesen MK, Baatrup G, Petersen C. et al. Screening individuals’ experiences of colonoscopy and colon capsule endoscopy; a mixed methods study. Acta Oncol 2019; 58 (Suppl. 01) S71-S76
- 5 Mikkelsen EM, Thomsen MK, Tybjerg J. et al. Colonoscopy-related complications in a nationwide immunochemical fecal occult blood test-based colorectal cancer screening program. Clin Epidemiol 2018; 10: 1649-1655
- 6 Steffenssen MW, Al-Najami I, Baatrup G. Patient-reported minor adverse events after colonoscopy: a systematic review. Acta Oncol 2019; 58 (Suppl. 01) S22-S28
- 7 Eliakim R, Fireman Z, Gralnek IM. et al. Evaluation of the PillCam Colon capsule in the detection of colonic pathology: results of the first multicenter, prospective, comparative study. Endoscopy 2006; 38: 963-970
- 8 Moher D, Liberati A, Tetzlaff J. et al. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 2009; 6: e1000097
- 9 Whiting PF, Rutjes AW, Westwood ME. et al. QUADAS-2: a revised tool for the quality assessment of diagnostic accuracy studies. Ann Intern Med 2011; 155: 529-536
- 10 Reitsma JB, Glas AS, Rutjes AW. et al. Bivariate analysis of sensitivity and specificity produces informative summary measures in diagnostic reviews. J Clin Epidemiol 2005; 58: 982-990
- 11 Chu H, Cole SR. Bivariate meta-analysis of sensitivity and specificity with sparse data: a generalized linear mixed model approach. J Clin Epidemiol 2006; 59: 1331-1332
- 12 Lee J, Kim KW, Choi SH. et al. Systematic review and meta-analysis of studies evaluating diagnostic test accuracy: a practical review for clinical researchers – Part II. Statistical methods of meta-analysis. Korean J Radiol 2015; 16: 1188-1196
- 13 Holleran G, Leen R, O’Morain C. et al. Colon capsule endoscopy as possible filter test for colonoscopy selection in a screening population with positive fecal immunology. Endoscopy 2014; 46: 473-478
- 14 Igawa A, Oka S, Tanaka S. et al. Evaluation for the clinical efficacy of colon capsule endoscopy in the detection of laterally spreading tumors. Digestion 2017; 95: 43-48
- 15 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
- 16 Parodi A, Vanbiervliet G, Hassan C. et al. Colon capsule endoscopy to screen for colorectal neoplasia in those with family histories of colorectal cancer. Gastrointest Endosc 2018; 87: 688
- 17 Pecere S, Senore C, Hassan C. et al. Accuracy of colon capsule endoscopy for advanced neoplasia. Gastrointest Endosc 2020; 91: 406
- 18 Voska M, Zavoral M, Grega T. et al. Accuracy of colon capsule endoscopy for colorectal neoplasia detection in individuals referred for a screening colonoscopy. Gastroenterol Res Pract 2019; 2019: 5975438
- 19 Akyuz U, Yilmaz Y, Ince AT. et al. Diagnostic role of colon capsule endoscopy in patients with optimal colon cleaning. Gastroenterol Res Pract 2016; 2016: 2738208
- 20 Ota Y, Yamada A, Kobayashi Y. et al. Diagnostic capability of colon capsule endoscopy for advanced colorectal cancer: a pilot study. Dig Endosc 2017; 29: 695-701
- 21 Eliakim R, Yassin K, Niv Y. et al. Prospective multicenter performance evaluation of the second-generation colon capsule compared with colonoscopy. Endoscopy 2009; 41: 1026-1031
- 22 Rex DK, Adler SN, Aisenberg J. et al. Accuracy of capsule colonoscopy in detecting colorectal polyps in a screening population. Gastroenterology 2015; 148: 948-967
- 23 Spada C, Hassan C, Munoz-Navas M. et al. Second-generation colon capsule endoscopy compared with colonoscopy. Gastrointest Endosc 2011; 74: 581-589
- 24 Hagel AF, Gabele E, Raithel M. et al. Colon capsule endoscopy: detection of colonic polyps compared with conventional colonoscopy and visualization of extracolonic pathologies. Can J Gastroenterol Hepatol 2014; 28: 77-82
- 25 Leighton JA, Rex DK. A grading scale to evaluate colon cleansing for the PillCam COLON capsule: a reliability study. Endoscopy 2011; 43: 123-127
- 26 Spada C, Pasha SF, Gross SA. et al. Accuracy of first- and second-generation colon capsules in endoscopic detection of colorectal polyps: a systematic review and meta-analysis. Clin Gastroenterol Hepatol 2016; 14: 1533-1543
- 27 Kastenberg D, Bertiger G, Brogadir S. Bowel preparation quality scales for colonoscopy. World J Gastroenterol 2018; 24: 2833-2843
- 28 Ohmiya N, Hotta N, Mitsufuji S. et al. Multicenter feasibility study of bowel preparation with castor oil for colon capsule endoscopy. Dig Endosc 2019; 31: 164-172
- 29 van Rijn JC, Reitsma JB, Stoker J. et al. Polyp miss rate determined by tandem colonoscopy: a systematic review. Am J Gastroenterol 2006; 101: 343-350
- 30 Ahn SB, Han DS, Bae JH. et al. The miss rate for colorectal adenoma determined by quality-adjusted, back-to-back colonoscopies. Gut Liver 2012; 6: 64-70
- 31 Buijs MM, Steele RJC, Buch N. et al. Reproducibility and accuracy of visual estimation of polyp size in large colorectal polyps. Acta Oncol 2019; 58 (Suppl. 01) S37-S41
- 32 Liu X, Faes L, Kale AU. et al. A comparison of deep learning performance against health-care professionals in detecting diseases from medical imaging: a systematic review and meta-analysis. Lancet Digit Health 2019; 1: e271-e297
- 33 Blanes-Vidal V, Baatrup G, Nadimi ES. Addressing priority challenges in the detection and assessment of colorectal polyps from capsule endoscopy and colonoscopy in colorectal cancer screening using machine learning. Acta Oncol 2019; 58 (Suppl. 01) S29-S36
- 34 Ojidu H, Palmer H, Lewandowski J. et al. Patient tolerance and acceptance of different colonic imaging modalities: an observational cohort study. Eur J Gastroenterol Hepatol 2018; 30: 520-525
- 35 Ferlitsch M, Moss A, Hassan C. et al. Colorectal polypectomy and endoscopic mucosal resection (EMR): European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline. Endoscopy 2017; 49: 270-297