The Future of Colon Capsule Endoscopy

The Future of Colon Capsule Endoscopy


Professor Angus Watson, Council Member of the Royal College of Surgeons of Edinburgh and clinical lead for colon capsule endoscopy in Scotland, provides an overview of the recent Colon Capsule Endoscopy Conference which took place on April 21. 


As healthcare workers, you will be fully aware of the impact significant clinical backlogs are having on patients and healthcare professionals across the UK as we navigate through the aftermath of the pandemic. 

Crises, fuel, innovation and the pandemic have given us a fresh appetite to look for and adopt new ways of delivering services in both health and social care.

I was delighted to have been part of the recent Colon Capsule Endoscopy (CCE) International Conference, held on April 21, which notably, was the first of its kind where knowledge was shared around the current and future use of CCE in gastrointestinal disease. As many of you will know, CCE is a procedure in which the patient, rather than having a colonoscopy, swallows a capsule with cameras inside. The two cameras take an incredible 50,000 images of inside the bowel looking for any signs of problems or disease. 

The hybrid event saw more than 200 attendees come together to share patient experiences and the ways in which we can make the pathway even more efficient, with the potential to allow patients to have a CCE from the comfort of their own home or at their local GP practice.

As clinical lead for the CCE in Scotland, I have had the privilege of seeing first-hand just how impactful the service - named ScotCap in Scotland - can be, and how it has become a very acceptable alternative to the colonoscopy, of which there are around half a million procedures performed across the UK each year.  

As we continue to recover from the impact of the pandemic, it is hugely important to take a further look at alternative ways to detect bowel cancer early, so that people can be treated as quickly as possible and so hospital waiting lists do not cause delays in diagnoses. 

During the conference, held jointly by RCSEd and NHS Scotland Centre for Sustainability, we heard some hugely important comments from Genevieve Edwards, the Chief Executive of Bowel Cancer UK, who said that designing diagnostic services with patients at the centre was essential. She commented that the patient feedback about the CCE service (from over 1000 patients) had been very good.

We also had a series of presentations on the evidence base for CCE, alongside a description of the international experience of the test from Professor Gunnar Baatrup, who many of you will know as an international authority on colon capsule endoscopy. 

Discussions were led on future models of the colon capsule, with Dr David Rigby, who is a GP from the Western Isles, describing how general practice is about to start a world-first GP-led colon capsule endoscopy service on the Islands

I was delighted to update colleagues on our future plans to do home deliveries of the procedures to patients, as ultimately, we see that colon capsule endoscopy could be done within a person’s home. This of course, would be very popular with the patients, particularly given the stigma around having a colonoscopy. 

As a College, we’re very passionate about sustainable healthcare and if you look at all the plastics involved in the colonoscopy pathway, we see CCE as environmentally advantageous because the volume of single use items is significantly less and potentially there will be a considerable saving in patient carbon-miles if they can access CCE in or close to their homes.

I am proud to say that Scotland is the world’s first place to have the colon capsule as part of its normal service. ScotCap 2.0 will be an elevated version of this and will be about how we take the service and make it even better.

The conference afforded me the opportunity to engage with so many brilliant members of the profession and it was great to get everyone involved so we can compare notes and plan future trials and innovations. 

We can see that CCE may make accessing a bowel diagnostic easier. Patients who are scared of having a colonoscopy may find CCE much easier, particularly if they do not want to be in a hospital. I truly believe that CCE will have an impact on addressing health inequalities and will have the potential to reduce the number of patients experiencing bowel cancer.

By summer 2022, every health board will have the service in Scotland. Together we must raise awareness of the fact that CCE is available and that it is an alternative option for patients.  


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