BACKGROUND & AIMS:: Colon capsule endoscopy (CCE) is a non-invasive and painless technique used to explore the colon without sedation or air insufflation. We performed a systematic review and meta-analysis to assess the accuracy of CCE in detecting colorectal polyps. METHODS:: The MEDLINE, EMBASE, and SCOPUS databases were searched, from 2006-2009, for the terms 'colon capsule' and 'Pillcam colon'; searches included abstracts. Studies were included that focused on detecting colorectal polyps with CCE and that were verified using within-subject reference colonoscopy. The risk of bias within each study was ascertained according to QUADAS recommendations. The per-patient sensitivity and specificity were calculated for polyps of any size and for significant findings (polyps >/=6 mm in size or >3 in number). Forest plots were produced based on random-effect models. The risk of bias across studies was assessed using the I2 statistic, meta-regression, and Egger's test. RESULTS:: Eight studies provided data on 837 patients; the prevalences of polyps and significant findings were 57% and 27.4%, respectively. CCE sensitivity for polyps of any size and significant findings were 71% and 68%, respectively. CCE specificity for polyps of any size and significant findings were 75% and 82%, respectively. High levels of heterogeneity (I2>75%) were not detected. Moderate heterogeneity was partially explained by the different design of individual studies. CCE identified 16 of the 21 cancerous lesions detected by colonoscopy (pooled sensitivity=76%). CONCLUSIONS:: CE sensitivity for polyps and significant findings compares favorably with other noninvasive CRC screening strategies. CCE specificity is likely to be underestimated because reference colonoscopy examination results are blinded.
Spada, C., Hassan, C., Marmo, R., Petruzziello, L., Riccioni, M. E., Zullo, A., Cesaro, P., Pilz, J., Costamagna, G., Meta analysis shows Colon Capsule Endoscopy is effective in detecting Colorectal polyps., <<CLINICAL GASTROENTEROLOGY AND HEPATOLOGY>>, 2010; (Giugno): 616-622 [http://hdl.handle.net/10807/32660]
Meta analysis shows Colon Capsule Endoscopy is effective in detecting Colorectal polyps.
Spada, Cristiano;Hassan, Cesare;Petruzziello, Lucio;Riccioni, Maria Elena;Cesaro, Paola;Costamagna, Guido
2010
Abstract
BACKGROUND & AIMS:: Colon capsule endoscopy (CCE) is a non-invasive and painless technique used to explore the colon without sedation or air insufflation. We performed a systematic review and meta-analysis to assess the accuracy of CCE in detecting colorectal polyps. METHODS:: The MEDLINE, EMBASE, and SCOPUS databases were searched, from 2006-2009, for the terms 'colon capsule' and 'Pillcam colon'; searches included abstracts. Studies were included that focused on detecting colorectal polyps with CCE and that were verified using within-subject reference colonoscopy. The risk of bias within each study was ascertained according to QUADAS recommendations. The per-patient sensitivity and specificity were calculated for polyps of any size and for significant findings (polyps >/=6 mm in size or >3 in number). Forest plots were produced based on random-effect models. The risk of bias across studies was assessed using the I2 statistic, meta-regression, and Egger's test. RESULTS:: Eight studies provided data on 837 patients; the prevalences of polyps and significant findings were 57% and 27.4%, respectively. CCE sensitivity for polyps of any size and significant findings were 71% and 68%, respectively. CCE specificity for polyps of any size and significant findings were 75% and 82%, respectively. High levels of heterogeneity (I2>75%) were not detected. Moderate heterogeneity was partially explained by the different design of individual studies. CCE identified 16 of the 21 cancerous lesions detected by colonoscopy (pooled sensitivity=76%). CONCLUSIONS:: CE sensitivity for polyps and significant findings compares favorably with other noninvasive CRC screening strategies. CCE specificity is likely to be underestimated because reference colonoscopy examination results are blinded.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.