The UK nationwide observational study of colon capsule: CAP ACCESS study.
Lei, Ian Io Ibrahim, Hussain Jardine, Ruari Koulaouzidis, Anastasios Beshyah, Waleed Mcgreevy, Conor Arefin, Aamerrashad Jarocki, Matthew Ambler, Tracey Kiladze, Giorgi
Lei, Ian Io
Ibrahim, Hussain
Jardine, Ruari
Koulaouzidis, Anastasios
Beshyah, Waleed
Mcgreevy, Conor
Arefin, Aamerrashad
Jarocki, Matthew
Ambler, Tracey
Kiladze, Giorgi
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Affiliation
University Hospitals Coventry and Warwickshire NHS Trust; University of Warwick; NHS Highland, Inverness; South Warwickshire University NHS Foundation Trust; et al.
Other Contributors
Lee, Thomas
Parisi, Ioanna
Bhandare, Anirudh
Shekhar, Chander
Dear, Keith
Jennings, Jason
Aly, Mohamed
McStay, Mary
Anderson, Simon
Selvaraj, Emmanuel
Watson, Angus
Parsons, Nicholas
Parisi, Ioanna
Bhandare, Anirudh
Shekhar, Chander
Dear, Keith
Jennings, Jason
Aly, Mohamed
McStay, Mary
Anderson, Simon
Selvaraj, Emmanuel
Watson, Angus
Parsons, Nicholas
Publication date
2025-05-13
Subject
Collections
Research Projects
Organizational Units
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Abstract
Background: Colon capsule endoscopy (CCE) is increasingly used as an alternative to optical endoscopy (OE), particularly in Europe. However, challenges like low completion rates, inadequate bowel preparation, high conversion to OE, and discrepancies in findings remain. Accurate polyp size measurement in CCE is essential to avoid unnecessary procedures due to size overestimation.
Objective(s): This retrospective study analysed real-world data to compare polyp size measurements between CCE, OE, and histopathology (HP) and assess the impact on the need for further procedures.
Methods: Data from 2508 participants across 12 UK centres were analysed, with 4898 polyps identified via CCE. Polyps were matched with OE and HP reports based on size, location, morphology, sequence, and count, including those meeting ≥3 criteria. Regional data from Scotland and England were compared.
Results: Half of the CCE patients required follow-up OE, with 29 % undergoing colonoscopy. Among these, 32 % required OE for polypectomy, and 18 % due to incomplete CCE. In these cases, CCE overestimated polyp size by an average of 2.5 mm compared to HP and 2.7 mm compared to OE, leading to 17.3 % of potentially deferrable procedures.
Conclusion: one in six participants had a further procedure reflecting the overestimation of polyp size. AI advancement could enhance polyp measurement accuracy and reduce unnecessary procedures whilst improving the cost-effectiveness of CCE.
Keywords: Bowel preparation; Capsule endoscopy; Colon capsule endoscopy; Colonoscopy; Completion rate; Histopathology; Panenteric capsule endoscopy.
Citation
Lei II, Ibrahim H, Jardine R, Koulaouzidis A, Beshyah W, Mcgreevy C, Arefin A, Jarocki M, Ambler T, Kiladze G, Hunt C, Pillay L, Patel S, Nair SS, Nizar ZY, Fisher I, Arasaradnam RP; CAP ACCESS study group. The UK nationwide observational study of colon capsule: CAP ACCESS study. Dig Liver Dis. 2025 Jul;57(7):1465-1472. doi: 10.1016/j.dld.2025.04.010. Epub 2025 May 13.
Type
Article