Meta-analysis Shows Colon Capsule Endoscopy Is Effective in Detecting Colorectal Polyps

• Published in: Clinical gastroenterology and hepatology Vol. 8; no. 6; pp. 516 - 522.e8
• Main Authors: Spada, Cristiano, Hassan, Cesare, Marmo, Riccardo, Petruzziello, Lucio, Riccioni, Maria Elena, Zullo, Angelo, Cesaro, Paola, Pilz, Julia, Costamagna, Guido
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.06.2010
• Subjects: Advanced Neoplasia; Capsule Endoscopy - methods; Colorectal Cancer; Colorectal Cancer Screening; Colorectal Neoplasms - diagnosis; Female; Gastroenterology and Hepatology; Humans; Male; Middle Aged; PillCam Colon; Polyps - diagnosis; Sensitivity and Specificity; CT; PillCam Colon; CCE; CRC; CI; Colorectal Cancer; Advanced Neoplasia; MeSH; PRISMA; I 2; Colorectal Cancer Screening; computed tomography; Preferred Reporting Items for Systematic Reviews of Meta-Analyses; confidence interval; Medical Subject Headings; interstudy heterogeneity; colon capsule endoscopy
• ISSN: 1542-3565; 1542-7714; 1542-7714
• DOI: 10.1016/j.cgh.2010.02.018

Colon capsule endoscopy (CCE) is a noninvasive and painless technique used to explore the colon without sedation or air insufflation. We performed a systematic review and meta-analysis to assess the accuracy of CCE in detecting colorectal polyps. The MEDLINE, EMBASE, and SCOPUS databases were searched, from 2006 to 2009, for the terms “colon capsule” and “Pillcam colon”; searches included abstracts. Studies were included that focused on detecting colorectal polyps with CCE and that were verified using within-subject reference colonoscopy. The risk of bias within each study was ascertained according to Quality Assessment of Diagnostic Accuracy in Systematic Reviews recommendations. The per-patient sensitivity and specificity were calculated for polyps of any size and for significant findings (polyps, ≥6 mm in size or >3 in number). Forest plots were produced based on random-effect models. The risk of bias across studies was assessed using the interstudy heterogeneity statistic, meta-regression, and the Egger test. Eight studies provided data on 837 patients; the prevalences of polyps and significant findings were 57% and 27.4%, respectively. CCE sensitivity for polyps of any size and significant findings were 71% and 68%, respectively. CCE specificity for polyps of any size and significant findings were 75% and 82%, respectively. High levels of heterogeneity (interstudy heterogeneity, >75%) were not detected. Moderate heterogeneity partially was explained by the different design of individual studies. CCE identified 16 of the 21 cancerous lesions detected by colonoscopy (pooled sensitivity, 76%). CCE sensitivity for polyps and significant findings compares favorably with other noninvasive colorectal cancer screening strategies. CCE specificity is likely to be underestimated because reference colonoscopy examination results are blinded.