The Background

Every week across West Yorkshire and Harrogate just under 400 patients are referred on an urgent cancer pathway for investigations for colorectal cancer. For over 95% of these patients, the diagnosis will not be cancer.

Over the last six months, Covid-19 has caused a reduction in the number of patients who have been presenting to their GP, but it is expected that over the coming weeks and months, many of these patients will attend with symptoms over and above the expected weekly numbers.  Alongside this, endoscopy provision has been significantly impacted by the pandemic, resulting in a backlog of patients. The impact of social distancing and additional protective measures mean that this situation is likely to continue for the foreseeable future.  This has meant that many patients who would normally be investigated for cancer using traditional colonoscopy have had to wait longer.

More information about endoscopy

Endoscopy guidance from NHS England - Clinical guide for triaging patients with lower gastrointestinal symptoms 16 June 2020, Version 1

What is Colon Capsule Endoscopy (CCE)?

Colon Capsule Endoscopy, also known as Pillcam, offers a new alternative to traditional colonoscopy.   The patient swallows a capsule that contains a small disposable camera. The capsule is the size of a large vitamin pill, (approximately 26mm X 11mm).  Once the patient has taken the capsule and has the receiver in place to capture the images, they are free to go home. The camera takes thousands of pictures as it travels along the patient’s gut, which takes about eight hours. These pictures are transmitted wirelessly to a data recorder worn by the patient at their waist.  After the procedure, the pictures are uploaded and a trained nurse or clinician will review the images for signs of abnormalities.

Partners In The Project

Benefits

One major benefit in the context of Covid-19 is that the procedure is non-aerosol generating, thereby reducing the risk to both the patient and healthcare professional.  It can be delivered outside the endoscopy suite in a separate clinical room, in both primary and secondary care. There are benefits to the patient in terms of the ease of the procedure and that it can be delivered in some cases outside the hospital environment.

Why offer the test now?

Within West Yorkshire and Harrogate a number of NHS Trusts are working on the use of Colon Capsule Endoscopy as an alternative diagnostic for patients who have been identified through a Faecal Immunochemical Testing or FIT test as being at low risk of cancer.  At the moment these patients would be facing an increased wait for colonoscopy.

More Information About Colorectal Cancer

Cancer Research UK - About Bowel Cancer

Macmillan - Information And  Support - Bowel Cancer

Bowel Cancer UK - About Bowel Cancer