Endoscopy 2018; 50(04): S93-S94
DOI: 10.1055/s-0038-1637306
ESGE Days 2018 oral presentations
21.04.2018 – Colon: CRC screening
Georg Thieme Verlag KG Stuttgart · New York

DIAGNOSTIC PERFORMANCE OF COLON CAPSULE ENDOSCOPY (CCE2). A PROSPECTIVE MULTICENTER STUDY IN A SCREENING SETTING

C Spada
1   Fondazione Poliambulanza, Digestive Endoscopy Unit, Brescia, Italy
2   A. Gemelli University Hospital, Digestive Endoscopy Unit, Rome, Italy
,
C Hassan
3   Nuovo Regina Margherita Hospital, Endoscopy Unit, Rome, Italy
,
M Pennazio
4   AOU Città della Salute e della Scienza, University Endoscopy Unit, Turin, Italy
,
Z Adrián-de-Ganzo
5   Canarias University Hospital, Endoscopy Unit, Las Palmas, Spain
,
E Rondonotti
6   Valduce Hospital, Digestive Endoscopy Unit, Como, Italy
,
E Quintero
5   Canarias University Hospital, Endoscopy Unit, Las Palmas, Spain
,
S Pecere
2   A. Gemelli University Hospital, Digestive Endoscopy Unit, Rome, Italy
,
N Segnan
7   AOU Città della Salute e della Scienza, Epidemiology and Screening Unit – CPO, Turin, Italy
,
G Costamagna
2   A. Gemelli University Hospital, Digestive Endoscopy Unit, Rome, Italy
8   IHU-Strasbourg, Institute of Image-Guided Surgery, Strasbourg, France
,
C Senore
7   AOU Città della Salute e della Scienza, Epidemiology and Screening Unit – CPO, Turin, Italy
› Author Affiliations
Further Information

Publication History

Publication Date:
27 March 2018 (online)

Also available at
 

Aims:

To assess CCE-2 diagnostic accuracy in screenees with a positive faecal immunochemical test (FIT) in population based programmes for colorectal cancer (CRC) screening.

Methods:

subjects aged 50 to 69, with a positive FIT, examined in 4 population programmes in Italy and Spain were enrolled. Same test (Eiken co.) and same positivity cut-off (20µgr. Hb/gr. faeces) were adopted. Screenees were asked to perform CCE-2, followed by colonoscopy (TC). TC was performed the same day if CCE-2 was excreted before 2 p.m.. TC was scheduled for the following morning after an additional bowel preparation if CCE-2 was excreted after 2pm. Bowel preparation for CCE-2 included a splitted PEG-based regimen and NaP and Gastographin as boosters. CCE-2 video was read by an endoscopist blinded to the results of TC. The main outcomes were CCE-2 sensitivity and specificity for advanced neoplasia, when using different size thresholds for TC referral (i.e. > 5 or > 9 mm polyp).

Results:

222 subjects were enrolled and 203 completed both CCE-2 and TC. Quality of bowel preparation for CCE-2 was adequate in 88.5% of cases. A complete examination was achieved in 96.6% of cases with TC and in 88.2% with CCE-2. TC detected an AN in 32.4% of screenees with complete CCE-2 exam. CCE-2 sensitivity for AN was 75.9% and 89.7% when using the higher (≥1 polyp > 9 mm; TC referral rate; 36.3%) or the lower (≥1 polyp > 5 mm; TC referral rate 52.5%) thresholds; AN specificity were 82.6% and 65.3%, respectively.

Conclusions:

Our results confirm in a high-prevalence population the findings from previous reports showing a high sensitivity of CCE-2 for significant colorectal lesions. The lower CCE-2 specificity as compared to previous reports is likely related to the choice of AN as the main outcome, as opposed to large polyps (any histology).