Video capsule endoscopy has been rolled out to NHS patients across the UK for cancer testing. This is within the context of a post-pandemic ‘peak’ phase, where cancer screening and treatment has become a greater priority.

What is Video Capsule Endoscopy?

Video capsule endoscopy is a procedure that uses a tiny wireless camera in the shape of a capsule which can be swallowed in order to take thousands of colour photos of the digestive tract.

It is roughly the size of a large multivitamin pill. Currently, each PillCam (a type of video capsule endoscopy) takes more than 50,000 images. This process enables doctors to see the inside of the small intestine, which is normally difficult to reach with the more traditional endoscopy procedure.

Photos are transmitted to a recording device worn around the patient’s waist which are then transferred onto a computer. Specialised computer software will produce a video via the collated images. Therefore, the videos can be stored and reviewed by doctors and nurses as part of the patient’s records.

In contrast, traditional endoscopy involves passing a long tube equipped with a camera, which is a far more invasive procedure for the patient. It only takes a few snapshots of photos.

What does Video Capsule Endoscopy help with?

Capsule endoscopy has several useful applications such as detecting the source of GI bleeding, helping diagnose conditions such as Crohn’s disease, celiac disease and ulcers as well as identifying polyps or tumours. More recently, there has been an increased focus on the value of capsule endoscopy in the realm of cancer screening and treatment, especially bowel and colon cancers. Bowel cancer is the third most common form of cancer worldwide and with screening, it is also one of the most preventable forms.

The pandemic has caused backlogs in cancer screening and treatment. For instance, 200,000 UK patients were waiting for an endoscopy last November which is 49% higher than the previous year. Genevieve Edwards, Chief Executive of Bowel Cancer UK stated that “Bowel cancer is treatable and curable, especially when diagnosed early. The Covid-19 crisis has severely impacted screening for the disease, which may mean people of screening age whose bowel cancer goes undiagnosed may suffer worse outcomes as a result of a later diagnosis.”

An additional complication, regarding traditional endoscopy, caused by the pandemic has been that meeting Covid-19 compliant infection control measures has resulted in the overall process taking longer, reducing the number of patients able to have this procedure.

Future Plans

As the country comes out of the COVID-19 ‘peak’, the NHS has prioritised resolving this backlog via innovative methods. Under NICE Guidelines, the UK usually uses video capsule endoscopy after a negative initial endoscopy, which means bleeding of unknown origin, that does not show in traditional endoscopy.

However, as of March 2021, the NHS has decided to roll out capsule endoscopy pills to test for cancer. An initial 11,000 patients across England will receive these capsules. The interesting aspect is that this procedure will be performed in the comfort of the patient’s own home. Professor Peter Johnson, NHS clinical director for cancer said that “the cameras will help to speed up the checks, catching more cancers early when they are easier to treat.”

For some specialists, this has been viewed as a promising new technology which will create significant advantages for patients.