CCE is a viable alternative to colonoscopy for the investigation of intermediate- and low-risk patients with gastrointestinal symptoms: results of a pilot study

Colon capsule endoscopy (CCE) is a recommended viable alternative to colonoscopy for colonic visualization in a variety of clinical settings. 1 In keeping with the evidence that patients without alarm symptoms are at low risk of colorectal neoplasia, the European Society of Gastrointestinal Endoscopy guideline of 2012 approved CCE use in average risk patients as a non-invasive option. 2, 3 Several non-invasive tests have been evaluated in this setting, including the use of faecal biomarkers, fecal calprotectin (FC) and fecal immunological test (FIT) and other imaging modalities, particularly CT colonography. 4, 5

Biomarkers are now widely incorporated into patient triaging and vetting procedures and are considered a useful means to priorities cases. 6, 7 Biomarkers alone can rule-out significant disease in only a minority and imaging tests are still required in the majority of patients to detect both neoplastic and non-neoplastic conditions. 4 As such, evaluation of symptomatic patients still represents a significant burden for colonoscopy services and viable alternatives are needed to help meet increasing demand. 8