Colon Capsule Gives CT Colonography Another Drubbing
Douglas K. Rex, MD, MASGE, reviewing Cash BD, et al. Gut 2020 Dec 18.
In a prospective randomized trial including 320 average-risk screenees, polyps ≥6 mm were found more often with colon capsule endoscopy than with CT colonography (CTC; 31.6% vs 8.6%, respectively). The yield of polyps ≥10 mm was 13.5% with capsule colonoscopy and 6.3% with CTC. Sensitivity for polyps ≥6 mm was 79.2% with capsule colonoscopy versus 26.8% with CTC. For polyps ≥10 mm, sensitivity was 85.7% with capsule colonoscopy and 50% with CTC.
COMMENTCapsule colonoscopy is approved by the U.S. Food and Drug Administration (FDA) for incomplete colonoscopy and colonoscopy in patients with gastrointestinal bleeding who are poor candidates for colonoscopy or sedation. Recently, capsule colonoscopy received a Category I CPT code for incomplete colonoscopy. Thus far, capsule colonoscopy is neither FDA-approved nor has a reimbursement code for screening. The indications for capsule colonoscopy and CTC are similar, and in recent trials, capsule colonoscopy has been consistently superior to CTC for polyp detection.
Note to readers: At the time we reviewed this paper, its publisher noted that it was not in final form and that subsequent changes might be made.
CITATION(S)
Cash BD, Fleisher MR, Fern S, et al. Multicentre, prospective, randomised study comparing the diagnostic yield of colon capsule endoscopy versus CT colonography in a screening population (the TOPAZ study). Gut 2020 Dec 18. (Epub ahead of print) (https://doi.org/10.1136/gutjnl-2020-322578)
