domingo, 4 de junio de 2017

Colon Capsule to Screen for Colorectal Neoplasia in Subjects with a Family History of Colorectal Cancer. - PubMed - NCBI

2017 May 26. pii: S0016-5107(17)31926-0. doi: 10.1016/j.gie.2017.05.023. [Epub ahead of print]

Colon Capsule to Screen for Colorectal Neoplasia in Subjects with a Family History of Colorectal Cancer.

Parodi A1, Vanbiervliet G2, Hassan C3, Hebuterne X2, De Ceglie A4, Filiberti RA5, Spada C6, Conio M7.

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Abstract

BACKGROUND AND AIMS:

Colon capsule endoscopy (CCE) has been recognized as an alternative for colorectal cancer (CRC) screening in average risk subjects. To prospectively assess the accuracy of CCE as a screening tool in first-degree relatives (FDRs) of subjects with CRC using optical colonoscopy (OC) with segmental unblinding as reference standard.

METHODS:

Consecutive patients admitted with CRC diagnosis (index case, IC) were prospectively evaluated, and invited to contact their FDRs. Available FDRs were invited to undergo CCE, and OC on the following day with segmental unblinding of CCE results. Sensitivity, specificity, and predictive values (PPV/NPV) of CCE were assessed for detecting subjects with any polyp ≥6 mm and ≥10 mm.

RESULTS:

177 FDRs (median age: 57.0 years; 54.8% females) identified from 211 ICs were included. Both CCE and OC were complete in all the included FDRs. Overall, CCE identified 51 of 56 FDRs with polyps ≥6 mm (sensitivity 91%; 95% CI, 81-96), and correctly classified as negative 107 of 121 participants without lesions ≥6 mm (specificity 88%; 95% CI, 81-93). Per-patient positive and negative predictive values for >6 mm lesions were 78% (95% CI, 67-87) and 95% (95% CI, 90-98), respectively. CCE detected 24 of 27 patients with polyps ≥10 mm and correctly classified as negative 142 of 150 patients, corresponding to 89% and 95% sensitivity and specificity. Post-CCE referral rates to colonoscopy were 37% and 18%, respectively.

CONCLUSION:

CCE is an accurate method to screen FDRs of CRC patients and could be offered as an alternative to those who decline or are unfit for colonoscopy screening.