COLON CAPSULE ENDOSCOPY VERSUS COLONOSCOPY IN PATIENTS AT AVERAGE OR INCREASED RISK OF COLORECTAL CANCER

Sylvie Sacher-Huvelin (1) , Emmanuel Coron (2) , Marianne Gaudric (3) , Lucie Planche (4) , Robert Benamouzig (5) , Vincent Maunoury (6) , Bernard Filoche (7) , Muriel Frederic (8) , Jean-Christophe Saurin (9) , Clement Subtil (10) , Stéphane Lecleire (11) , Christopher Cellier (12) , Dimitri Coumaros (13) , Denis Heresbach (14) , Jean Paul Galmiche (15)

1 CIC
2 Gastroenterology, Hepatology and Nutritional Support
3 GASTROENTEROLOGY
4 biostatistics
5 gastroenterology
6 GASTROENTEROLOGY
7 St. Philibert Hospital
8 CHRU Nancy - Centre Hospitalier Régional Universitaire de Nancy
9 gastroenterology
10 Service d'Hépato-Gastro-Entérologie
11 Service d'Hépato-Gastroentérologie [CHU Rouen]
12 GASTROENTEROLOGY
13 GASTROENTEROLOGY
14 Service des Maladies de l'Appareil Digestif [CHU Rennes]
15 Gastroenterology

Background - Aim Colon capsule endoscopy (CCE) is a new, non-invasive technology. We conducted a prospective, multicentre trial to compare CCE and colonoscopy in asymptomatic subjects enrolled in screening or surveillance programmes for the detection of colorectal neoplasia. Methods Patients underwent CCE on day one and colonoscopy (gold standard) on day two. CCE and colonoscopy were performed by independent endoscopists. Results 545 patients were recruited. CCE was safe and well-tolerated. Colon cleanliness was excellent or good in 52% of cases at CCE. Five patients with cancer were detected by colonoscopy, of whom two were missed by CCE. CCE accuracy for the detection of polyps ≥ 6 mm was 39% (95% CI 30-48) for sensitivity, 88% (95% CI 85-91) for specificity, 47% (95% CI 37-57) for positive predictive value and 85% (95% CI 82-88) for negative predictive value. CCE accuracy was better for the detection of advanced adenoma, in patients with good or excellent cleanliness and after re-interpretation of the CCE videos by an independent expert panel Conclusion Although well-tolerated, CCE cannot replace colonoscopy as a first line investigation for screening and surveillance of patients at risk of cancer. Further studies should pay attention to colonic preparation. Clinicaltrial.gov number NCT00436514.

Mots clés: Medicine

Sylvie Sacher-Huvelin, Emmanuel Coron, Marianne Gaudric, Lucie Planche, Robert Benamouzig, et al.. COLON CAPSULE ENDOSCOPY VERSUS COLONOSCOPY IN PATIENTS AT AVERAGE OR INCREASED RISK OF COLORECTAL CANCER. Alimentary Pharmacology and Therapeutics, 2010, 32 (9), pp.1145. ⟨10.1111/j.1365-2036.2010.04458.x⟩. ⟨hal-00577003⟩