Meta analysis shows Colon Capsule Endoscopy is effective in detecting Colorectal polyps

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.