Associations between patient factors and successful colon capsule endoscopy – A prospective cohort study

Aim To establish patient factors associated with a successful colon capsule endoscopy (CCE) test. Method This prospective cohort study used data collected from patients who underwent CCE as part of the ScotCap evaluation prior to April 2020. A CCE was defined as successful if the capsule visualized the whole colon and rectum (complete test) with sufficient bowel cleansing to permit assessment of the colonic mucosa (adequate bowel preparation). Factors from patients in symptomatic and surveillance groups were analysed for associations with a successful test, complete test, adequate bowel preparation and requirement for further procedure using univariate, multivariate logistic, least absolute shrinkage and selection operator regression. Results Data from 263 symptomatic and 137 surveillance patients were analysed. There was an association between a symptomatic patient's age and a successful test (OR = 0.97, 95% CI: 0.95–0.99), adequate bowel preparation (OR = 0.97, 95% CI: 0.94–1.00) and further procedure requirement (OR = 1.04, 95% CI: 1.02–1.06). An association was found, for symptomatic patients, between a faecal immunochemical test result in the range 10–399 μg/g and a further procedure (OR = 2.32, 95% CI: 1.23–4.48). In patients undergoing surveillance for previous colorectal cancer (OR = 0.42, 95% CI: 0.18–0.97), had previous bowel resection surgery (OR = 0.43, 95% CI: 0.19–0.98) or took a beta blocker medication (OR = 0.32, 95% CI: 0.11–0.88), an association was found with further procedure requirement. Conclusions Among symptomatic patients, younger age was associated with obtaining a successful CCE test. Clinicians could consider patient selection based on these results to improve the rate of successful testing in clinical practice.