TBA (24S124)

Back-to-Back Colon Capsule Endoscopy And Colonoscopy In Both Screening and Symptomatic Population

Author(s)

E. Gibbons, L. Keating, R. Farrell, C Smyth, O. B. Kelly, B. Hall

Department(s)/Institutions

Gastroenterology Department, Connolly Hospital, Blanchardstown, Dublin 15

Introduction

Colon capsule endoscopy (CCE) has been demonstrated to be comparable to colonoscopy and better than CT colonography (CTC) for the detection of colonic pathology. Challenges include high re-investigation rates.

Aims/Background

To assess the role of CCE with faecal immunohistochemical testing (FIT) as a non-invasive, diagnostic tool in symptomatic and screening populations attending Connolly Hospital

Method

Prospective participants were identified from endoscopy waiting list office. Consenting participants undergo CCE the day prior to scheduled colonoscopy. CCEs are read by expert readers. Participants are sent FIT kits to complete prior to CCE. Primary outcomes are polyp detection rates (PDR).

Results

79 back-to-back procedures were completed January 2023-February 2024 (M: F 49:30, mean age 59.6, range 35-78). Most common indications for colonoscopy were surveillance 41.7%, PR bleeding 20% and diarrhoea/ IBD assessment 16.5%. PDR for all CCE was higher than colonoscopy but not statistically significant (56.9% versus 50.6%, p =0.45). PDR for complete CCE was higher at 68%, trending toward significance (p =0.052). 79% supplied FITs prior to CCE. CCE PDR for all polyps when FIT < 50 ng/ml was 51% versus 73% with FIT > 50 ng/ml (p=0.08). CCE PDR with FIT <50ng/ml reduced to 18.9% when only polyps >6mm were included (p=0.009).

Conclusions

The increasing demand on colonoscopy waiting lists raises concerns regarding the ability of health services to deliver traditional endoscopy in a timely fashion. Alternative modalities are necessary and CCE has a role to play. There is a role for FIT testing as a triage tool prior to CCE to reduce reinvestigation rates.