New Pill May Screen for Colon Cancer

Early Colon Imaging Capsule Results ‘Encouraging’
By Salynn Boyles
WebMD Medical News
Reviewed by Louise Chang, MD

May 22, 2007 -- In the future, getting screened for colon cancer may be as simple as taking a pill.

Researchers say they are encouraged by early results from an ongoing study comparing a pill-delivered imaging device with colonoscopy for detection of colon polyps and colon cancer screening. Colon polyps are growths that can become cancerous.

Similar imaging devices, called PillCams, are already being used to screen for esophageal and small intestine disease.

But it is not yet clear if the same technology will prove to be a useful tool for colon cancer screening.

The camera ‘pill’, which is the size of a large multivitamin, travels though the body capturing images along the way -- at a speed of four images per second in the case of the colon cam.

Pill-based endoscopy requires at least as much prep to clean out the colon as is needed with colonoscopy, but the actual test involves little more from the patient than swallowing a pill.
Not as Accurate as Colonoscopy

Interim findings from an ongoing European trial with a target of 329 patients were presented Tuesday in Washington at an international meeting of digestive disease specialists.

Researcher Jacques Deviere, MD, of Brussel’s Erasme University Hospital reported on results from 84 patients who had the capsule imaging procedure followed by colonoscopy screening.

Standard preparation techniques for colonoscopy screening resulted in excellent to good imaging with the ingestible endoscopy technique in two-thirds of patients and fair to poor imaging in the remaining third.

The PillCam did not detect as many polyps as colonoscopy, but Deviere and colleagues concluded that it is accurate enough to be a useful tool for colon cancer screening.

A spokesman for the Israeli company that makes the pill camera, Given Imaging Ltd, tells WebMD that the goal is not to replace colonoscopy, but to offer an alternative to patients who are unable or unwilling to undergo the invasive procedure.

“It is not quite as good as colonoscopy, but it is much easier on the patient,” says Mark Gilreath. “There is no sedation and no hospitalization.”

Gilreath says the company hopes to win approval to sell the colon imaging device in the United States by the end of the year.
Many Patients May Need Both Tests

Philadelphia gastroenterologist and Gregory Ginsberg, MD, calls the concept of wireless capsule-delivered colon screening “compelling,” but he remains skeptical about the potential impact of the imaging technique.

“I am not optimistic that this will play a significant medical role,” he says.

Unlike colonoscopy, which can both find and remove suspicious polyps or abnormalities for biopsy, the colon pill camera’s only role is detection.

That means patients with suspicious areas detected with the camera device will end up having both procedures, each requiring time-consuming and uncomfortable prep to cleanse the colon.

About 30% of patients who undergo colonoscopy screenings have polyps that require biopsy, Ginsberg says. He is director of endoscopic services at the University of Pennsylvania School of Medicine.

“Theoretically, this could help us identify people who do and do not need [colonoscopy] screening, but there are many unanswered questions,” he says.

SOURCES: Digestive Disease Week 2007, Washington, May 21, 2007. Jacques Deviere, MD, researcher, COLON pilot study; professor of medicine, Brussels Erasme University Hospital; president, European Society of Gastrointestinal Endoscopy. Gregory Ginsberg, MD, professor of medicine, University of Pennsylvania Health System, Philadelphia. Mark Gilreath, chief marketing officer, Given Imaging Ltd., Yoqneam, Israel.
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