Capsule Endoscopy Found Inferior to Colonoscopy

Procedure has low rates of sensitivity and specificity for detecting polyps, advanced disease

WEDNESDAY, July 15 (HealthDay News) -- In the detection of colorectal polyps and cancer, capsule endoscopy has low rates of sensitivity and specificity compared to conventional colonoscopy, according to a study published in the July 16 issue of the New England Journal of Medicine.

Andre Van Gossum, M.D., of the Universite Libre de Bruxelles in Brussels, Belgium, and colleagues performed capsule endoscopy and conventional colonoscopy on 328 patients with abnormal findings at previous diagnostic procedures or with symptoms suggestive of colorectal cancer or polyps.

The researchers found that capsule endoscopy did not identify polyps at least 6 mm in 36 percent of the patients for whom colonoscopy identified such polyps (sensitivity and specificity, 64 and 84 percent, respectively) and did not identify colorectal cancer in five of the 19 patients for whom colonoscopy identified the disease. They also observed that the sensitivity and specificity of capsule endoscopy for all lesions was higher in patients with good or excellent bowel preparation.

"Colon capsule endoscopy has not yet been cleared for sale in the United States, but it is actively marketed in Europe," states the author of an accompanying editorial. "The current price for a capsule is approximately $1,150, which is not lower than the price of colonoscopy or computed tomographic colonography. With the capsule's relatively low sensitivity for the detection of colorectal lesions, its requirement for more extensive bowel-cleansing regimens as compared with colonoscopy and computed tomographic colonography, and its high cost, colon capsule endoscopy cannot be recommended at this time."

The study was supported by Given Imaging; two authors disclosed financial relationships with the company.

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