TOPLINE:

Patients who underwent colon capsule endoscopy (CCE) experienced significantly less pain than those who underwent colonoscopy or CT colonography, yet they expressed more concerns about its effectiveness and reported lower overall satisfaction with the procedure.

METHODOLOGY:

• Researchers conducted a structured patient experience survey at 50 secondary care pilot sites during 2021-2022 and compared experiences of CCE, colonoscopy, and CT colonography.
• Adult participants, including those referred for suspected colorectal cancer with a faecal immunochemical test result of ≤ 100 μg Hb/g faeces or awaiting 3-year postpolypectomy surveillance, were recruited from the NHS England CCE pilot.
• Overall, 927 of 1937 participants responded to the survey; these participants included those with the experience of CCE (n = 486; 54% women; 99% White), colonoscopy (n = 399; 50% women; 99% White), and CT colonography (n = 42; 50% women; 100% White).
• Gastrointestinal Endoscopy Satisfaction Questionnaire subscales were used to collect time‑based assessments — before, during, and after the procedure — of pain, discomfort, and overall health‑related quality of life.

TAKEAWAY:

• Only 2% of patients who underwent CCE vs 21% of those who underwent colonoscopy and 12% of those who underwent CT colonography reported pain (P < .001).
• A higher proportion of patients expressed concerns about the effectiveness of CCE vs colonoscopy and CT colonography (25% vs 11% and 12%; P < .001).
• Overall satisfaction in terms of diagnosis or reassurance was lower with CCE than with colonoscopy or CT colonography (74% vs 91% or 80%; P < .001).
• Reflecting on their preprocedural thinking, 18% of patients who underwent CCE said that they would have preferred a different procedure; however, this proportion was lower than that after colonoscopy (34%) and was comparable to that after CT colonography (20%).

IN PRACTICE:

"This study provides evidence to inform improvements to patient experience, particularly the need for appropriate patient selection to increase the likelihood of a conclusive index investigation, improved information and support. This will be key to the development of patient-facing and patient-engaged CCE diagnostic clinical services for the future," the authors wrote.

SOURCE:

This study was led by Veronica Dale, University of York, York, England. It was published online on October 13, 2025, in BMJ Open Gastroenterology.

LIMITATIONS:

The retrospective nature of the survey and the survey response rate of 48% may have introduced recollection and selection bias, respectively. Additionally, a small number of participants underwent CT colonography, which may have limited the comparative analyses.

DISCLOSURES:

This study was funded by NHS England through the Cancer Programme Team and supported by the Cancer Alliance Data, Evaluation and Analysis Service. The authors declared having no competing interests.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.