AN UP-TO-DATE REVIEW OF COLON CAPSULE ENDOSCOPY

Abstract

Fecal immunochemical test followed by colonoscopy is used for colorectal cancer screening throughout the world. Nowadays, colon capsule endoscopy (CCE) might be an alternative to colonoscopy, due to infrequent complications associated with CCE. According to the latest reports, the sensitivity of CCE for colon polyp ≥6mm is 84-94%, and its specificity is 64-88%. Diagnostic performance of CCE is superior to that of computed tomography (CT) colonography, and almost equivalent to that of colonoscopy. However, several issues remain to be addressed. In Japan, health insurance coverage for CCE is limited to patients in whom colonoscopy may be difficult. The medical expense of CCE is still too high. Patients must take a large amount of lavage solution. Because of these obstacles, CCE is not commonly performed in Japan. In February 2018, the Japanese Association for Capsule Endoscope (JACE) recommended the CCE regimen using castor oil, which may lead to increased performance of CCE. It is expected that the health insurance coverage for CCE will become the same as that for colonoscopy. As for management of inflammatory bowel disease, CCE might play an active role in assessing inflammation.