Evaluation of the clinical efficacy of colon capsule endoscopy in the detection of lesions of the colon: prospective, multicenter, open study

Background: Colon capsule endoscopy (CCE) is a new procedure for colon imaging. Limited information is available regarding visualization of flat colon lesions and patient acceptability in Japan. Objective: The aims of this study were to evaluate the sensitivity of CCE in detecting polyps and other lesions compared with optical colonoscopy (OC) and to evaluate its safety and acceptability in a cohort of Japanese patients. Design: A prospective, open-label, clinical study in Japan. Setting: Multicenter. Patients: Patients referred for OC because of personal history of polyps >= 6 mm or any other colon lesion that required endoscopic or surgical treatment. Interventions: CCE followed by therapeutic colonoscopy. Main Outcome Measurements: The primary endpoint was per-patient sensitivity of CCE in detecting significant colon lesion. The secondary endpoints were CCE safety and patient acceptability. Results: Sixty-six of the 72 patients enrolled in the study were evaluated for efficacy. The per-patient sensitivity was 94% (95% confidence interval [CI], 88.2%-99.7%). The per-polyp sensitivity was 86.6% (95% CI, 81.3%-91.9%) when pathology-confirmed polyps were considered true positives. There were no adverse events related to CCE, and the acceptability of CCE was high. Limitations: All patients had previously confirmed colon lesions, which may have falsely elevated the sensitivity of CCE. Conclusion: CCE had a high sensitivity for detecting significant colon lesions. CCE was safe and had a high level of patient acceptability.