Magnetically controlled capsule gastroscopy feasible for gastric cancer screening

Last Updated: 2018-05-28

By Rita Buckley

NEW YORK (Reuters Health) - Magnetically controlled capsule gastroscopy may be a safe and clinically effective way to screen large asymptomatic populations for gastric cancer, Chinese researchers say.

"Magnetically controlled capsule gastroscopy is a novel modality for gastric examination. It is noninvasive, requires no sedation, is portable, easy to perform, and has a comparable diagnostic accuracy to conventional esophagogastroduodenoscopy (EGD)," the authors write in Gastrointestinal Endoscopy, online May 9.

Dr. Zhuan Liao from Changhai Hospital, Second Military Medical University, in Shanghai, and colleagues studied 3,182 consecutive adults (62% male) who underwent magnetically controlled capsule gastroscopy from April to December 2016. Patients with ulcers or suspected malignancies were referred for EGD and biopsy.

Ninety-nine (99) medical examination centers in 29 provinces/autonomous regions/municipalities took part in the study. All participants were asymptomatic. The mean age was 44.8 (range, 18-94).

Seven patients (0.22%) were diagnosed with advanced gastric cancer and two (0.06%) with multiple cancerous lesions. Of those with cancer, four were male and three were female. All were older than 50 years, and the detection rate in this group was 0.74%. Lesions were identified in the esophagus, cardia, fundus, angulus and antrum; all were pathologically confirmed as adenocarcinoma.

Other focal lesions in the upper gastrointestinal tract were found in 567 individuals or 17.8% of the studied population; 36 patients had at least two lesion types.

Benign polyps were found in 10.4% of patients, gastric ulcers in 4.9% and submucosal tumors in 3.6%.

Dr. Sapna Syngal, research director at the Dana-Farber Cancer Institute's Center for Cancer Genetics and Prevention in Boston, told Reuters Health by email, "Gastric cancer has high mortality, but there are known screening methods, like EGD, that improve survival when employed early."

"Patient barriers to EGD can be addressed by magnetically controlled capsule gastroscopy with EGD, thus lending credence to its use as a screening procedure in asymptomatic early gastric cancer patients," said Dr. Syngal, who was not involved in the study.

In this study, she noted, the diagnostic accuracy of magnetically controlled capsule gastroplasty was comparable to, if not better than, EGD, and that its completion rate was 99.6% with no adverse events reported.

"Magnetically controlled capsule gastroplasty is a novel technique that could be performed without an endoscopist or endoscopic equipment, possibly leading to a national screening program," she said.

According to Dr. Syngal, the main limitations of the study aside from its retrospective design, are that it included no analysis of small-bowel pathology; that it might include a high-risk population; and that its sample size was modest.

Dr. Liao did not respond to requests for comments.

SOURCE: https://bit.ly/2GWOCOX

Gastrointest Endosc 2018.