Endoscopy 2021; 53(S 01): S101-S102
DOI: 10.1055/s-0041-1724516
Abstracts | ESGE Days
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The True False Negative Rate of Colon Capsule Endoscopy is Low

S Semenov
1   Tallaght University Hospital, Gastroenterology, Dublin, Ireland
2   Trinity College Dublin, Trinity Academic Gastroenterology Group, Dublin, Ireland
,
Ismail MS
1   Tallaght University Hospital, Gastroenterology, Dublin, Ireland
2   Trinity College Dublin, Trinity Academic Gastroenterology Group, Dublin, Ireland
,
F O’Hara
1   Tallaght University Hospital, Gastroenterology, Dublin, Ireland
2   Trinity College Dublin, Trinity Academic Gastroenterology Group, Dublin, Ireland
,
S O’Donnell
1   Tallaght University Hospital, Gastroenterology, Dublin, Ireland
,
A O’Connor
1   Tallaght University Hospital, Gastroenterology, Dublin, Ireland
,
N Breslin
1   Tallaght University Hospital, Gastroenterology, Dublin, Ireland
,
B Ryan
1   Tallaght University Hospital, Gastroenterology, Dublin, Ireland
,
D McNamara
1   Tallaght University Hospital, Gastroenterology, Dublin, Ireland
2   Trinity College Dublin, Trinity Academic Gastroenterology Group, Dublin, Ireland
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Aims Colon capsule endoscopy (CCE) is an established diagnostic tool for colonic pathology. There is a lack of clinical data on the true capsule false negative (FN) rates. We aimed to assess the causes of missed pathology in a CCE cohort.

Methods Single-centre retrospective 9-year study. 2nd generation CCEs with at least one follow-up colonoscopy within 18 months were identified. Missed pathology on the index capsule were identified by comparing reports against colonoscopy. Indication, bowel preparation, missed lesion/pathology characteristics (type, significance, location and histology) were collated. FN studies were re-read by experts unblinded to CCE and colonoscopy findings. On re-reading, new lesions/pathology were verified by an expert panel. Missed lesions identified on re-reading the original study were considered reader error, those not identified on re-reading were considered true FN events.

Results Of 532 CCEs, 210 (39 %) had a comparative colonoscopy (mean interval 4 months; range 0-18). In all, 49 (23 %) had missed pathology, 30/49 (61 %) reached the section of the colon with the missed pathology.

Of the 30 discrepant studies, 24 (80 %) had adequate preparation. Indications included 14 (47 %) polyp surveillance, 12 (40 %) GI symptoms, 3 (10 %) IBD and 1 (3 %) screening. Missed pathology included diminutive polyps 18 (60 %), polyps ≥6mm 8 (27 %), inflammation 4 (13 %). Missed lesions were evenly distributed, 14 right and 16 left colon. Of polyps 18/26 (69 %) were adenomas. No cancers were missed.

Reader error accounted for 23/30 (77 %) cases, while 7/30 (23 %) CCEs were true FN events. Missed pathology was due to true capsule error 7/210 (3.3 %), reader error 23/210 (11 %), incomplete studies 19/210 (9 %). Poor preparation was a factor in 6/30 (20 %) cases. Missed pathology was more likely a result of reader error versus capsule error, OR 3.2 (p = 0.018, 95 %CI;1.22-8.80).

Conclusions Our study suggests a low true CCE false negative rate. Reader error accounts for most missed pathology.

Citation: Semenov S, Ismail MS, O’Hara F et al. eP15 THE TRUE FALSE NEGATIVE RATE OF COLON CAPSULE ENDOSCOPY IS LOW. Endoscopy 2021; 53: S101.



Publication History

Article published online:
19 March 2021

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