Colon capsule endoscopy versus CT colonography in FIT-positive colorectal cancer screening subjects: a prospective randomised trial—the VICOCA study

BMC Medicine

Miquel Serra-Burriel¹  Maria Vila-Casadesús²  Àngels Pozo³  Jaume Grau³  Anna Serradesanferm⁴  Isis Karina Araujo⁵  Oriol Sendino⁵  Cristina Romero⁵  María López-Cerón⁵  Cristina Rodríguez de Miguel⁵  Begoña González-Suárez⁶  Henry Córdova⁶  Josep Llach⁷  Francesc Balaguer⁷  Maria Pellisé⁷  Glòria Fernández-Esparrach⁷  Àngels Ginès⁷  Antoni Castells⁷  Andrés Cárdenas⁸  David Flores⁹  Juan Ramón Ayuso^1,10  Mario Pagés^1,10 

[1] Center for Research in Health and Economic, Pompeu Fabra University, Barcelona, Spain;Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain;Department of Preventive Medicine and Epidemiology, Hospital Clinic of Barcelona, Barcelona, Spain;Department of Preventive Medicine and Epidemiology, Hospital Clinic of Barcelona, Barcelona, Spain;Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain;Gastroenterology Department, Hospital Clinic of Barcelona, Barcelona, Spain;Gastroenterology Department, Hospital Clinic of Barcelona, Barcelona, Spain;Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain;Gastroenterology Department, Hospital Clinic of Barcelona, Barcelona, Spain;Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain;Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Catalonia, Spain;Gastroenterology Department, Hospital Clinic of Barcelona, Barcelona, Spain;Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Catalonia, Spain;Radiology Department, Hospital Clinic of Barcelona, Barcelona, Spain;Radiology Department, Hospital Clinic of Barcelona, Barcelona, Spain;Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Catalonia, Spain;

关键词: Colon capsule endoscopy;    CT colonography;    Colorectal cancer screening;   

DOI  :  10.1186/s12916-020-01717-4

来源: Springer

【 摘 要 】

BackgroundColon capsule endoscopy (CCE) and CT colonography (CTC) are minimally invasive techniques for colorectal cancer (CRC) screening. Our objective is to compare CCE and CTC for the identification of patients with colorectal neoplasia among participants in a CRC screening programme with positive faecal immunochemical test (FIT). Primary outcome was to compare the performance of CCE and CTC in detecting patients with neoplastic lesions.MethodsThe VICOCA study is a prospective, single-centre, randomised trial conducted from March 2014 to May 2016; 662 individuals were invited and 349 were randomised to CCE or CTC before colonoscopy. Endoscopists were blinded to the results of CCE and CTC.ResultsThree hundred forty-nine individuals were included: 173 in the CCE group and 176 in the CTC group. Two hundred ninety individuals agreed to participate: 147 in the CCE group and 143 in the CTC group. In the intention-to-screen analysis, sensitivity, specificity and positive and negative predictive values for the identification of individuals with colorectal neoplasia were 98.1%, 76.6%, 93.7% and 92.0% in the CCE group and 64.9%, 95.7%, 96.8% and 57.7% in the CTC group. In terms of detecting significant neoplastic lesions, the sensitivity of CCE and CTC was 96.1% and 79.3%, respectively. Detection rate for advanced colorectal neoplasm was higher in the CCE group than in the CTC group (100% and 93.1%, respectively; RR = 1.07; p = 0.08). Both CCE and CTC identified all patients with cancer. CCE detected more patients with any lesion than CTC (98.6% and 81.0%, respectively; RR = 1.22; p = 0.002).ConclusionAlthough both techniques seem to be similar in detecting patients with advanced colorectal neoplasms, CCE is more sensitive for the detection of any neoplastic lesion.Trial registrationClinicalTrials.gov Identifier: NCT02081742. Registered: September 16, 2013.

【 授权许可】

CC BY