**5. Colon capsule endoscopy, Quo Vadis?**

In the year 2011 the European Society of Gastrointestinal Endoscopy(ESGE) recognized the potential that colon capsule endoscopy offers and ordered the establishment of evidence based guidelines for colon capsule endoscopy[8]. This initiative was endorsed by the gov‐ erning board of ESGE.

Technical concerns in relation to colon capsule endoscopy were addressed. Will the colon be adequately cleansed for high quality inspection? Will the power of the batteries within the capsule supply adequate energy to transmit images from the colon until excretion of the capsule? The experts therefore formulated precise guidelines and devoted an entire section on how to perform capsule endoscopy. To achieve high quality colon capsule endoscopy (good bowel preparation, high rate of capsule passage rate through entire colon and proper reading) strict implementation of all guidelines must be followed (diet, laxatives, booster in‐ gestion, controlled frame rate during reading).

Here are some of the attractive features of colon capsule endoscopy that are mentioned in the published guidelines.


equal uptake (adherence to participate in colon cancer screening) was assumed, it became an efficient option when it was assumed that uptake of CCE would be higher than that of colonoscopy for CRC screening, a premise that has not been demonstrated yet."

three previous studies with the first generation colon capsule had a very similar design as the present studies with colon capsule 2 and are thus comparable. Secondly, good bowel cleansing is a determining factor for a successful study. Good bowel cleansing was obtained at similar rates in the studies with colon capsule 1 as in the new studies with colon capsule 2. Thirdly, capsule exrection of a capsule still transmitting images is a prerequisite for a suc‐ cessful colon capsule study. Capsule excretion rates of the studies with colon capsule 1 and the studies with colon capsule 2 were the same. The only factor which set this second gener‐ ation colon capsule study apart from the previous studies is the new technological platform. It is for this reason that we credit the improvement in technology for the improved diagnos‐

Colon capsule 2's negative predictive value of 97% is very high and is clinically very mean‐ ingful. The physician discussing the results of a negative colon capsule 2 study with his pa‐ tient can reassure her/him that that a negative colon capsule 2 study has a 97% accuracy that

The fact that the smart features of DR3 enable communication with the patient has opened

In the year 2011 the European Society of Gastrointestinal Endoscopy(ESGE) recognized the potential that colon capsule endoscopy offers and ordered the establishment of evidence based guidelines for colon capsule endoscopy[8]. This initiative was endorsed by the gov‐

Technical concerns in relation to colon capsule endoscopy were addressed. Will the colon be adequately cleansed for high quality inspection? Will the power of the batteries within the capsule supply adequate energy to transmit images from the colon until excretion of the capsule? The experts therefore formulated precise guidelines and devoted an entire section on how to perform capsule endoscopy. To achieve high quality colon capsule endoscopy (good bowel preparation, high rate of capsule passage rate through entire colon and proper reading) strict implementation of all guidelines must be followed (diet, laxatives, booster in‐

Here are some of the attractive features of colon capsule endoscopy that are mentioned in

**•** "CCE (Colon capsule endoscopy) has consistently been shown to be a very safe proce‐ dure: no major complication has been reported in over 1500 procedures, of which around 40% were in asymptomatic individuals. CCE also appears to be a feasible procedure, with a very low rate of technical failures (i. e. 3%) and a high capsule excretion rate of about

**•** "A previous cost–effectiveness analysis has compared first-generation CCE with colono‐ scopy in a screening setting. Although CCE was not a cost-effective alternative when

the door to offer colon capsule examination as an out of clinic procedure [7].

**5. Colon capsule endoscopy, Quo Vadis?**

248 Colonoscopy and Colorectal Cancer Screening - Future Directions

gestion, controlled frame rate during reading).

tic sensitivity of 30%.

there are no polyps.

erning board of ESGE.

the published guidelines.

90%".


We will dwell on two mentioned issues raised in the European Guidelines, namely the use of capsule colonoscopy in screening for colonic polyps and the use of capsule endoscopy in incomplete colonoscopy.
