Capsule colonoscopy, a patented procedure developed by Given Imaging in Yokne'am in which patients swallow a small video capsule that then examines the colon for polyps, could be a promising new tool for colon cancer screening in at-risk patients, according to findings presented at the 71st Annual Scientific Meeting of the American College of Gastroenterology in the US.
However, Given Imaging capsule colonoscopy is not yet approved by the US Food and Drug Administration and its still experimental. The Israeli company's swallowable capsule for viewing the small intestine and esophagus are FDA approved and regularly used in many countries, including the US and Israel.
Dr. Blair Lewis of New York's Mount Sinai School of Medicine and colleagues conducted a blinded trial study to assess the efficacy of capsule colonoscopy in screening high-risk patients for colon polyps and cancer. The study examined 51 patients, average age 54; 31 were examined for routine screening while 16 had family histories of colon cancer. Three patients had blood in their stool and one had a personal history of colon polyps. Patients twice drank fluids to empty their bowel (one for the capsule colonoscopy and one for the virtual colonoscopy (VC) and colonoscopy). The doctors reading the capsules did not provide results to the doctors performing the VC or colonoscopy. At the end of the colonoscopy, the study was unblinded for all results and colonoscopy was repeated to assure that nothing was missed. Seventeen pre-cancerous polyps were found in 15 of the 51 patients. Sixteen of 17 were detected by colonoscopy, 12 of 17 were detected by capsule colonoscopy and five of 17 were detected by virtual colonoscopy.
In another study presented at the meeting, researchers compared Given Imaging's capsule endoscopy to the standard colonoscopy in the detection of polyps. Patients who participated in the study were either at high risk for colorectal cancer, scheduled for colorectal cancer surveillance or symptomatic. Based on the results, capsule endoscopy detected 70 percent of polyps while 80% of polyps were detected using standard colonoscopy.
"Improvements in the procedure may increase capsule endoscopy completion and polyp detection rates. Further studies are needed to evaluate capsule endoscopy accuracy in the average risk population," said Rambam Medical Center Prof. Rami Eliakim.
According to Lewis, "Capsule colonoscopy is a promising new technology for visualizing the colon. Furthermore, capsule colonoscopy may complement colonoscopy in cases where colonoscopy is contraindicated, in incomplete colonoscopy, and for patients unwilling to undergo standard colonoscopy. Capsule colonoscopy appears to be more sensitive than virtual colonoscopy in detecting small colon polyps and it has potential for colorectal cancer screening."