Pill Cam Not as Good as Colonoscopy

It’s swallowable, allows for visualization of the colon, and, in the opinion of one expert, has a likely role in the future of colorectal cancer screening.

PillCam Colon has a lower chance of detecting bowel polyps and colon cancers, compared with colonoscopy, according to a study published in the New England Journal of Medicine 2014.

In a large study of 320 patients with known or suspected colonic disease, the likelihood of capsule endoscopy for detecting polyps that were 6 mm or larger was 64% despite the appeal of this portable minimally invasive technology.

In the study, all capsule endoscopies were followed by colonoscopy within a day’s time.

Capsule endoscope will not replace colonoscopy anytime soon and will have very selective use.
If and when it is approved for use in the colon, the device’s best use will be in patients who do not want to have a colonoscopy, those at high risk for colonoscopy complications, and those in which the endoscopist was not able to complete the procedure.

Colonoscopy is the best test for detecting colon polyps.
Although acknowledging that colonoscopy is an invasive procedure that requires sedation, time off work, and transportation assistance for the patient,  Colonoscopy is the best test for detecting colon polyps and the only test that has the ability to remove colon polyps and prevent progression to colon cancer.

Nevertheless, in the future colon cancer screening with Pill cam colon may be comparable to colonoscopy. We watch this space with interest.

Of the 19 cancers detected by colonoscopy, 14 were detected by the capsule endoscopy (sensitivity, 74%).

New Engl J Med. 2009;361:264-270.