Swallowable Capsule-Camera Instead of Endoscopy: Now in Patients

A miniature camera the size of a capsule that is swallowed and that then transmits images of the inside of the gut can reveal cancer and gastrointestinal diseases. The device, which will be studied in a trial conducted by the National Health Service (NHS) in England, is used by patients at home as a substitute for endoscopy.

“What sounds like sci-fi is now becoming a reality,” said Sir Simon Stevens, chief executive of NHS England. “These minute cameras pass through your body, they take two pictures per second checking for signs of cancer and other conditions like Crohn’s disease.”

The trial, announced on March 11, will initially involve 11,000 patients from 40 regions in England. Participants will be sent the colon capsule endoscopy to use at home.

The capsule typically takes 5 to 8 hours to pass through the digestive system. As the capsule passes through the bowel, images are sent to a data recorder in a shoulder bag.

The trial is being conducted by the University College London Hospitals NHS Foundation Trust (UCL), London, United Kingdom. The investigators have created a guide on using the device at home.

“Not only does colon capsule increase our diagnostic capacity, because it doesn’t require the resources of a dedicated hospital space to do the examination, it also allows us to do the examination in the patient’s home, so patients who may be shielding or cautious about going to a hospital can perform the procedure in the comfort of their own homes,” commented Ed Seward, MD, PhD, endoscopy lead at UCL.

The move is in response to a surge in patients coming forward for cancer checks after the slowdown in cancer services caused by the COVID-19 pandemic. In December, more than 200,000 people came forward, an increase of 13,000 over the same month the previous year.

Traditional endoscopy services are still being offered, although endoscopies take longer to conduct because of infection control measures that must be employed to ensure that patients who undergo endoscopies do not contract COVID-19. This in turn means fewer people can undergo endscopies over a given period.

“We welcome any initiative that seeks to simplify and improve the early diagnosis of gastrointestinal disease and, in particular, colorectal cancer, which unfortunately is still responsible for many avoidable deaths,” said Alastair McKinlay, MD, president of the British Society of Gastroenterology.

“Colon capsule is a promising new technology that may offer a real advantage for some patients. For this reason, we welcome the opportunity for a proper service evaluation so that both the limitations and advantages of this technique can be properly assessed,” he said.

“This has the potential to make a huge difference for people with bowel cancer symptoms and could help the NHS to prioritize those who urgently need further tests,” added Genevieve Edwards, chief executive at Bowel Cancer UK.

No funding for the study has been disclosed. No relevant financial relationships have been disclosed.

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