Predictive Factors for Colon Capsule Endoscopy Reinvestigation Rates: Insights from the CESCAIL Study.
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Authors
Lee, Tom
Issue Date
2025
Type
Article
Language
en
Keywords
Alternative Title
Abstract
Aims
Colon capsule endoscopy (CCE) has emerged as an alternative to traditional colonoscopy for low-risk patients. However, CCE's lower completion rate and its limitations, such as the inability to perform biopsies or remove polyps, frequently lead to conversion to conventional colonoscopy (CCC). This study aims to identify factors that predict challenges with bowel cleansing, capsule excretion rates, pathology detection, and the likelihood of requiring reinvestigation following CCE.
Methods
This prospective study analysed data from patients who underwent CCE as part of the CESCAIL study between November 2021 and June 2024 across 14 centres in the United Kingdom. The study investigated predictive factors associated with CCE outcomes, examining variables such as patient demographics, comorbidities, medications, and laboratory results from both symptomatic and polyp surveillance groups. Statistical analyses, including LASSO, linear, and logistic regression, were employed to identify significant associations.
Results
A total of 603 participants were analysed. Elevated f-Hb levels (OR=1.48, 95% CI: 1.18–1.86, p=0.0002) and smoking (OR=1.44, 95% CI: 1.01–2.11, p=0.047) showed significant associations with CCC. After adjusting for confounders, the area under the curve (AUC) for elevated f-Hb in predicting CCC was 0.62. Diabetes was associated with poor bowel preparation (OR=0.40, 95% CI: 0.18–0.87, p=0.022). Alcohol use (p=0.004), smoking (p=0.003), psychological conditions (p=0.001), and haemoglobin levels (p=0.046) were significantly linked to the number of polyps, while the use of antidepressants (p=0.003) and beta-blockers (p=0.001) was associated with polyp size.
Conclusions
Non-smokers with lower f-Hb levels are less likely to require conversion to conventional colonoscopy (CCC). Optimising patient selection criteria is essential to reduce the colonoscopy conversion rate. Validating our findings across diverse populations could support the development of a robust CCE Conversion Scoring System (CECS), ultimately enhancing the cost-effectiveness of CCE in the future.
Description
Citation
Lei, I., Parisi, I., Bhandare, A. et al. (2025) Predictive Factors for Colon Capsule Endoscopy Reinvestigation Rates: Insights from the CESCAIL Study. Endoscopy ; 57(supp_2) : S605-S606.
Publisher
License
Journal
Endoscopy
Volume
Issue
PubMed ID
ISSN
1438-8812