Camera in a pill: the latest silver bullet?

Capsule camera endoscopy is a diagnostic technology recently introduced to the NHS in an attempt to diagnose colon and bowel cancer earlier. An alternative to a traditional endoscopy, capsule camera technology is a small camera, the size of a vitamin pill (23 mm), which a patient swallows. As the capsule travels through the body, it takes images every 2 seconds which are then relayed to a recorder attached to the patient’s waist, like a belt. This is worn for 5-8 hours, during which the patient can continue with their day as normal. These images can then be downloaded, and a report is issued to help in diagnosing the patient.

Since traditional endoscopies and colonoscopies already exist, is there a need or demand for this new technology? 

Unfortunately, due to COVID-19, cancellations and wait times for possible cancer patients have increased. Furthermore, due to social distancing, appointments for endoscopies has become a longer process and thus fewer patients can be seen in the same amount of time. Compared to December 2019 where 41,906 patients waited longer than 6 weeks for a diagnostic test, December 2020 saw a shocking 350,000 patients in England waiting for more than 6 weeks for a diagnostic test. Ultimately, cancers being caught late due to the increased wait times and NHS backlog can lead to potentially avoidable deaths.

Therefore, a diagnostic technique which can be completed quickly at home by the patient themselves, instead of using precious hospital space and staff’s time, may result in a huge increase in diagnostic capacity. Judging from the wait time statistics, this is absolutely critical. More importantly, COVID-19 has dramatically increased the need to carry out testing at home, as vulnerable patients can perform the procedure without putting themselves at further risk.

Introducing the use of colon capsule cameras to 11,000 NHS patients, is a step in working towards the NHS’s long-term plan to diagnose three-quarters of tumours at an early stage, compared to the current half of tumour diagnoses.

However, it is a well-known fact that NHS wait times have been increasing long before the effects of COVID-19, so why has this technology only just been introduced? Professor Peter Johnson, NHS England’s clinical director for cancer, told the Independent: “From the cutting-edge technology of these colon capsules to Covid protected hubs and chemotherapy home deliveries, the NHS has fast tracked new ways of treating and diagnosing cancer – all while responding to the coronavirus pandemic”.

However, capsule cameras have been used clinically in the USA since 2001. Arguably, this suggests they are not cutting-edge at all. If they are cheaper, use less resources, and increase early diagnosis, why is this 20-year-old technology only now arriving in the NHS? It seems COVID19 has been the key in finally unlocking the colon capsule camera’s clinical use.

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Rosie Matthews

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June 2022
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