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The comparison of the efficiency of colon capsule endoscopy and optical colonoscopy in patients with positive immunochemical fecal occult blood test
06/2019 MUDr. Michal Volka; MUDr. Tomáš Grega; MUDr. Gabriela Vojtěchová; Mgr. Ondřej Ngo; RNDr. Ondřej Májek, Ph.D.; Mgr. Barbora Bůčková; doc. MUDr. Ilja Tachecí, Ph.D.; MUDr. Marek Beneš; prof. MUDr. Jan Bureš, CSc.; prof. MUDr. Julius Špičák, CSc.; prof. MUDr. Miroslav Zavoral, Ph.D.; doc. MUDr. Štěpán Suchánek, Ph.D.
Background: Fecal immunochemical tests (FIT) have been used as an initial test in CRC screening programs. However, majority of patients don't have advanced neoplasia on colonoscopy. Colon capsule endoscopy (CCE) has the potential to reduce the need for optical colonoscopy (OC).
Main aim of the study was negative predictive value (NPV) of the second generation of colon capsule endoscopy (CCE2) for large polyps (≥ 10 mm). The secondary aims were accuracy of detection of all polyps (polyps ≥ 6 mm and ≥ 10 mm) and cancers, number of complications and target population acceptance of both methods (CCE2 and OC).
Material and methods: In this multicenter (three gastroenterology units) feasibility study, second generation of colon capsule endoscopy (CCE2) has been prospectively compared with OC in persons with positive semi-quantitative FIT with cut-off level 75 ng/ml. Colonoscopy was performed within 10 hours after capsule ingestion. CCE2 videos were viewed independently by a nurse and a physician, both blinded to the results of OC. Complications were assessed as serious (bleeding, perforation) or mild to moderate. The methods of acceptance were evaluated based on the questionnaire completed after both procedures (CCE2 and OC) were finished. The interim analysis of results is presented.
Results: From April 2016, 248 individuals have been enrolled; data from 178 persons has been analyzed. During optical colonoscopy, polyps were diagnosed in 144 persons (81%), polyps ≥ 6 mm and ≥ 10 mm in 90 (51%) and 47 (26%) persons, respectively. The sensitivity of CCE2 for polyps ≥ 6 mm and ≥ 10 mm was 82% (95% confidence interval [CI]: 73-89%) and 79% (95% CI: 64-89%), respectively. The specificity for polyps ≥ 6 mm and ≥ 10 mm reached 85% (95% CI: 76-92%) and 92% (95% CI: 86-96%), respectively. The negative predictive value of CCE2 for polyps ≥ 10 mm was 92% (95% CI: 86-96%). Nurses identified 73 polyps ≥ 6 mm of 90 (83%) and 37 polyps ≥ 10 mm of 47 (79%) found on OC. A total of 119 patients (66%) preferred CCE2 as the primary screening method. Conclusion: Second generation of colon capsule has appeared to have a high negative predictive value for the detection of clinically relevant colorectal neoplasia in screening population. This method might be considered as an adequate tool for colorectal cancer screening.
ENTIRE ARTICLE
Background: Fecal immunochemical tests (FIT) have been used as an initial test in CRC screening programs. However, majority of patients don't have advanced neoplasia on colonoscopy. Colon capsule endoscopy (CCE) has the potential to reduce the need for optical colonoscopy (OC).
Main aim of the study was negative predictive value (NPV) of the second generation of colon capsule endoscopy (CCE2) for large polyps (≥ 10 mm). The secondary aims were accuracy of detection of all polyps (polyps ≥ 6 mm and ≥ 10 mm) and cancers, number of complications and target population acceptance of both methods (CCE2 and OC).
Material and methods: In this multicenter (three gastroenterology units) feasibility study, second generation of colon capsule endoscopy (CCE2) has been prospectively compared with OC in persons with positive semi-quantitative FIT with cut-off level 75 ng/ml. Colonoscopy was performed within 10 hours after capsule ingestion. CCE2 videos were viewed independently by a nurse and a physician, both blinded to the results of OC. Complications were assessed as serious (bleeding, perforation) or mild to moderate. The methods of acceptance were evaluated based on the questionnaire completed after both procedures (CCE2 and OC) were finished. The interim analysis of results is presented.
Results: From April 2016, 248 individuals have been enrolled; data from 178 persons has been analyzed. During optical colonoscopy, polyps were diagnosed in 144 persons (81%), polyps ≥ 6 mm and ≥ 10 mm in 90 (51%) and 47 (26%) persons, respectively. The sensitivity of CCE2 for polyps ≥ 6 mm and ≥ 10 mm was 82% (95% confidence interval [CI]: 73-89%) and 79% (95% CI: 64-89%), respectively. The specificity for polyps ≥ 6 mm and ≥ 10 mm reached 85% (95% CI: 76-92%) and 92% (95% CI: 86-96%), respectively. The negative predictive value of CCE2 for polyps ≥ 10 mm was 92% (95% CI: 86-96%). Nurses identified 73 polyps ≥ 6 mm of 90 (83%) and 37 polyps ≥ 10 mm of 47 (79%) found on OC. A total of 119 patients (66%) preferred CCE2 as the primary screening method. Conclusion: Second generation of colon capsule has appeared to have a high negative predictive value for the detection of clinically relevant colorectal neoplasia in screening population. This method might be considered as an adequate tool for colorectal cancer screening.
Colorectal cancer screening
06/2019 MUDr. Tomáš Grega; MUDr. Gabriela Vojtěchová; Mgr. Ondřej Ngo; Mgr. Renata Chloupková; RNDr. Ondřej Májek, Ph.D.; prof. RNDr. Ladislav Dušek, Ph.D.; prof. MUDr. Miroslav Zavoral, Ph.D.; doc. MUDr. Štěpán Suchánek, Ph.D.
The Czech Republic belongs to countries with long-term decreasing incidence and mortality of colorectal cancer. An organized population screening program has a major contribution to positive epidemiological trends. Sufficient coverage of the target population by screening tests and monitoring of screening quality indicators are key to an effective screening program. The principles of the screening program are defined in the European Recommendations. Most quality indicators in the Czech Republic are fulfilled. Participation of the target population in colorectal cancer screening is still unsatisfactory, however, it is gradually increasing by introducing a population screening program. This article summarizes current epidemiology, screening settings and current results of the National Colorectal Cancer Screening Program in the Czech Republic.
ENTIRE ARTICLE
The Czech Republic belongs to countries with long-term decreasing incidence and mortality of colorectal cancer. An organized population screening program has a major contribution to positive epidemiological trends. Sufficient coverage of the target population by screening tests and monitoring of screening quality indicators are key to an effective screening program. The principles of the screening program are defined in the European Recommendations. Most quality indicators in the Czech Republic are fulfilled. Participation of the target population in colorectal cancer screening is still unsatisfactory, however, it is gradually increasing by introducing a population screening program. This article summarizes current epidemiology, screening settings and current results of the National Colorectal Cancer Screening Program in the Czech Republic.
The comparison of the efficiency of colon capsule endoscopy and optical colonoscopy
06/2018 MUDr. Michal Voška, MUDr. Tomáš Grega, MUDr. Gabriela Vojtěchová, Mgr. Ondřej Ngo, RNDr. Ondřej Májek, Ph.D., Mgr. Barbora Bůčková, MUDr. Ilja Tachecí, Ph.D., MUDr. Marek Beneš, prof. MUDr. Jan Bureš, CSc., prof. MUDr. Julius Špičák, CSc., prof. MUDr. Miroslav Zavoral, Ph.D., doc. MUDr. Štěpán Suchánek, Ph.D.
Background: Fecal immunochemical tests havebeen used as an initial test in colorectal cancer screening programs. However, majority of patients don't have advanced neoplasia on colonoscopy. Colon capsule endoscopy has the potential to reduce the need for optical colonoscopy. The main aim of the study was a negative predictive value of the second generation of colon capsule endoscopy for large polyps (? 10 mm). The secondary aims were: accuracy of detection of all polyps (polyps ? 6 mm and ? 10 mm) and cancers, the number of complications and target population acceptance of both methods (colon capsule endoscopy and optical colonoscopy).
Material and methods: In this multicentre (three gastroenterology units) feasibility study, the second generation of colon capsule endoscopy (CCE2) has been prospectively compared with OC in persons with positive semi-quantitative FIT with cut-off level 75 ng/ml. Colonoscopy was performed within 10 hours after capsule ingestion. CCE2 videos were viewed independently by a nurse and a physician, both blinded to the results of OC. Complications were assessed as severe (bleeding, perforation) or mild to moderate. The methods of acceptance were evaluated based on the questionnaire completed after both procedures (CCE2 and OC) were finished. The interim analysis of results is presented.
Results: From April 2016, 167 individuals have been enrolled; data from 95 persons have been analyzed. During the optical colonoscopy, polyps were diagnosed in 70 persons (74%), polyps ? 6 mm and ? 10 mm in 42 (44 %) and 26 (27 %) persons, respectively. The sensitivity of CCE2 for polyps ? 6 mm and ? 10 mm was 88 % (95% confidence interval [CI] 74-96 %) and 85 % (95% CI 65-96 %), respectively. The specificity for polyps ? 6 mm and ? 10 mm reached 85 % (95% CI 72-93 %) and 93 % (95% CI 84-98 %), respectively. The negative predictive value of CCE2 for polyps ? 10 mm was 94 % (95% CI 86-98 %). Nurses identified 36 polyps ? 6 mm of 42 (86 %) and 23 polyps ? 10 mm of 26 (88 %) found on OC. A total of 64 patients (68 %) preferred CCE2 as the primary screening method.
Conclusion: The second generation of colon capsule has appeared to have a high negative predictive value for the detection of clinically relevant colorectal neoplasia in a screening population. This method might be considered as an adequate tool for colorectal cancer screening.
ENTIRE ARTICLE
Background: Fecal immunochemical tests havebeen used as an initial test in colorectal cancer screening programs. However, majority of patients don't have advanced neoplasia on colonoscopy. Colon capsule endoscopy has the potential to reduce the need for optical colonoscopy. The main aim of the study was a negative predictive value of the second generation of colon capsule endoscopy for large polyps (? 10 mm). The secondary aims were: accuracy of detection of all polyps (polyps ? 6 mm and ? 10 mm) and cancers, the number of complications and target population acceptance of both methods (colon capsule endoscopy and optical colonoscopy).
Material and methods: In this multicentre (three gastroenterology units) feasibility study, the second generation of colon capsule endoscopy (CCE2) has been prospectively compared with OC in persons with positive semi-quantitative FIT with cut-off level 75 ng/ml. Colonoscopy was performed within 10 hours after capsule ingestion. CCE2 videos were viewed independently by a nurse and a physician, both blinded to the results of OC. Complications were assessed as severe (bleeding, perforation) or mild to moderate. The methods of acceptance were evaluated based on the questionnaire completed after both procedures (CCE2 and OC) were finished. The interim analysis of results is presented.
Results: From April 2016, 167 individuals have been enrolled; data from 95 persons have been analyzed. During the optical colonoscopy, polyps were diagnosed in 70 persons (74%), polyps ? 6 mm and ? 10 mm in 42 (44 %) and 26 (27 %) persons, respectively. The sensitivity of CCE2 for polyps ? 6 mm and ? 10 mm was 88 % (95% confidence interval [CI] 74-96 %) and 85 % (95% CI 65-96 %), respectively. The specificity for polyps ? 6 mm and ? 10 mm reached 85 % (95% CI 72-93 %) and 93 % (95% CI 84-98 %), respectively. The negative predictive value of CCE2 for polyps ? 10 mm was 94 % (95% CI 86-98 %). Nurses identified 36 polyps ? 6 mm of 42 (86 %) and 23 polyps ? 10 mm of 26 (88 %) found on OC. A total of 64 patients (68 %) preferred CCE2 as the primary screening method.
Conclusion: The second generation of colon capsule has appeared to have a high negative predictive value for the detection of clinically relevant colorectal neoplasia in a screening population. This method might be considered as an adequate tool for colorectal cancer screening.