The effect of implementing colon capsule endoscopy in colorectal cancer screening on participation and sociodemographic inequalities: A parallel group randomised controlled trial

IF 3.2 3区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Public Health Pub Date : 2026-01-01 Epub Date: 2025-11-20 DOI:10.1016/j.puhe.2025.106056

Ulrik Deding , Lasse Kaalby , Benedicte Schelde-Olesen , Henrik Bøggild , Thomas Bjørsum-Meyer , Anastasios Koulaouzidis , Morten Kobaek-Larsen , Marianne Kirstine Thygesen , Jonna Skov Madsen , Gunnar Baatrup , on behalf of the CareForColon2015 study group

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引用次数: 0

Abstract

Objectives

Significant sociodemographic inequalities in participation in colorectal cancer (CRC) screening programmes across the globe are evident. We aimed to investigate the effect of introducing colon capsule endoscopy (CCE) as a filter test in faecal immunochemical test (FIT)-based CRC screening on overall FIT participation and social inequalities in FIT participation.

Study design

We conducted a randomised controlled trial, randomising 368,452 individuals.

Methods

Both groups received an invitation to submit a FIT sample, which elicited a follow-up investigation if ≥ 20 μg haemoglobin/g faeces was detected. The control group followed the standard screening pathway and was referred for follow-up colonoscopy. The intervention group were free to choose between colonoscopy and colon capsule endoscopy.

Results

The overall FIT participation proportion was significantly lower in the intervention group (63.4 %), compared to the control group (64.9 %). All sociodemographic subgroups in the intervention group had lower participation proportions than their control group counterpart, with an average of 1.4 (range 0.3–2.7) percentage points lower participation. The odds of non-participation, divided by sociodemographic characteristics, were not significantly different between interventions and controls for any subgroup, except for those aged 55–59 in which the odds ratios for non-participation was 1.59 (1.54–1.65) in the control group and 1.48 (1.43–1.53) in the intervention group, comparing them to those aged above 70.

Conclusions

Introducing a free choice between colon capsule endoscopy and colonoscopy if FIT positive did not increase FIT participation in CRC screening. Further, it did not affect the pattern of social inequalities in FIT uptake.

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在结直肠癌筛查中实施结肠胶囊内窥镜对参与和社会人口不平等的影响：一项平行组随机对照试验

目的：在全球范围内，参与结直肠癌（CRC）筛查计划的社会人口不平等是显而易见的。我们的目的是研究在基于粪便免疫化学试验（FIT）的CRC筛查中引入结肠胶囊内窥镜（CCE）作为过滤试验对总体FIT参与和FIT参与的社会不平等的影响。研究设计我们进行了一项随机对照试验，随机抽取了368,452名受试者。方法邀请两组患者提交FIT样本，如果检测到≥20 μg血红蛋白/g，则进行随访调查。对照组遵循标准筛查途径，随访结肠镜检查。干预组可自由选择结肠镜检查和结肠胶囊内镜检查。结果干预组整体FIT参与比例（63.4%）显著低于对照组（64.9%）。干预组的所有社会人口亚组的参与率都低于对照组，平均参与率低1.4（范围0.3-2.7）个百分点。不参与的几率，按社会人口统计学特征划分，在任何亚组中，除了55-59岁的人群，对照组不参与的比值比为1.59(1.54-1.65)，干预组不参与的比值比为1.48(1.43-1.53)，与70岁以上的人群相比，没有显著差异。结论引入FIT阳性的结肠胶囊内镜和结肠镜的自由选择并没有增加FIT在结直肠癌筛查中的参与。此外，它并不影响FIT吸收方面的社会不平等模式。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Public Health 医学-公共卫生、环境卫生与职业卫生

CiteScore

7.60

自引率

0.00%

发文量

280

审稿时长

37 days

期刊介绍： Public Health is an international, multidisciplinary peer-reviewed journal. It publishes original papers, reviews and short reports on all aspects of the science, philosophy, and practice of public health.