Although swallowing a pill camera can give doctors a good picture of the colon, it is not as good as traditional colonoscopy at detecting precancerous growths and cancer, European researchers report.
The U.S. Preventive Services Task Force recommends traditional colonoscopy -- in which a doctor uses a 3-foot-long flexible camera to examine the colon -- as a screening test for colon cancer beginning at the age of 50 years and continuing until the age of 75 years.
Doctors have been looking into the pill camera method -- also known as capsule endoscopy -- because "limited...resources may restrict [traditional colonoscopy's] use in large, population-based screening programs, and many persons are reluctant to undergo colonoscopy because of its perceived inconvenience, discomfort, or embarrassment," according to the study in The New England Journal of Medicine.
Researchers have found that the pill camera method is safe, but exactly how it stacks up against traditional colonoscopy in detecting colon growths was unclear.
Dr. Andre Van Gossum, from Erasme University Hospital, Brussels, Belgium, and co-researchers used both methods in 328 patients with known or suspected colon growths. They used the PillCam COLON capsule (Given Imaging).
Traditional colonoscopy was better at finding small precancerous growths known as polyps as well as finding advanced tumors.
Capsule endoscopy detected 14 cancers, while standard colonoscopy detected these malignancies plus 5 additional cancers. The capsule's ability to pick up those tumors was related to how well the colon was cleaned out, by having the patient drink an electrolyte solution, before the procedure.
About 1 in 12 patients experienced a side effect, which was most often related to the drink given to them before the procedure, the report indicates.
One limiting factor for pill cameras is the life of their battery, but in more than 90 percent of patients, the capsule passed through the digestive system before the battery died, the researchers report.
The pill is actively marketed in Europe at a cost of 950 euros ($1,150), Dr. Michael Bretthauer, Oslo University Hospital Rikshospitalet, Norway, notes in a related editorial. Based on the findings of this study and the cost, however, "colon capsule endoscopy cannot be recommended at this time," Bretthauer writes.
SOURCE: New England Journal of Medicine, July 16, 2009.
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