Associations between patient characteristics and completeness of colon capsule endoscopy in colorectal cancer screening participants: a cross-sectional study

OBJECTIVE: Incomplete investigations challenge the clinical use of colon capsule endoscopy (CCE). This results in added cost to healthcare systems and added discomfort to patients. In order to potentially lower the re-investigation rate, we aimed to investigate the association between multiple patient characteristics and complete CCE. METHODS: In 2020, the CareForColon2015 (CFC2015) Trial was initiated in the Region of Southern Denmark, investigating the performance of CCE in colorectal cancer screening. Data from the CFC2015 Trial were combined with data from multiple national registers. Completion rates were calculated and their relation to the different patient characteristics was analysed in univariate and multivariate logistic regression models. RESULTS: We analysed 1472 participants, of whom 1016 (69.1%) had complete investigations. We investigated the associations between 17 patient characteristics and complete CCE investigation. The multivariate analysis showed that smokers and heavy drinkers had a higher probability of a complete investigation, with ORs of 1.69 (95% CI 1.12 to 2.55) and 2.72 (95% CI 1.52 to 4.87), respectively, compared with non-consumers. We also found that increasing income was associated with increased odds of CCE completion (OR 1.78, 95% CI 1.30 to 2.43, for the highest quartile). High body mass index (>40) and self-reported constipation or laxative use were significantly associated with incomplete CCE, with ORs of 0.40 (95% CI 0.17 to 0.97) and 0.65 (95% CI 0.47 to 0.90), respectively. CONCLUSION: This study tested multiple factors for association with CCE completion. The results indicate that some factors are associated with higher odds of completion, while others are associated with lower odds of completion. These results confirm that specific patient characteristics correlate with the odds of complete investigation. This can, in turn, be used to determine the individual diagnostic pathway. Additional studies are needed for less frequently reported characteristics and to further support these findings.