Over 20 years since its introduction, small bowel capsule endoscopy (SBCE) is now well established in many diagnostic algorithms, most notably obscure gastrointestinal bleeds.1 Colon capsule endoscopy (CCE) is a newer technique, with it’s second-generation system (PillCam COLON 2) only becoming commercially available in 2012.2-8 EGuidance from the European Society of Gastrointestinal Endoscopy (ESGE), updated in 2020, provided the first framework for healthcare providers with regards to indications, preparation, reporting and work up of findings for CCE.9 It advises that CCE is safe and appears accurate when used in average-risk individuals, and safe for use in those with incomplete colonoscopy and without stenosis. They recommend use of CCE if colonoscopy is not appropriate or not possible. They advise that there remains a paucity of studies based in the setting of screening, and in comparing CCE with radiological imaging or traditional endoscopic modalities.9
National screening programmes face significant challenges in attempting to deliver timely and cost-effective screening. Bowel Screen is a two-stage population based programme that currently offers free bowel screening to men and women aged 60-69 years in Ireland. National colonoscopy capacity has been a rate limiting step in expansion of this programme to those aged 55-74 years. Patient acceptance of colonoscopy as a screening tool is also low with uptake as low at 11% in certain subgroups of invitees.10 Effective, alternative screening pathways are required.
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