Work

Influence of deprivation and rurality on colon capsule endoscopy outcomes: a retrospective analysis of the ScotCap registry

Year: 2026

Type: article

Abstract: Objective To evaluate the influence of socioeconomic deprivation and rurality on colon capsule endoscopy (CCE) performance and downstream management in a remote National Health Service (NHS) population.Methods We performed a secondary analysis of 2480 patients undergoing CCE within NHS Highland between 2019 and 2024 using data from the ScotCap registry. Primary outcomes were bowel preparation adequacy and CCE completion. The secondary outcome was follow-up pathway (endoscopic vs non-endoscopic). Predictor variables included age, sex, Scottish Index of Multiple Deprivation (SIMD) quintile and Urban–Rural Classification (URC). Multivariable logistic regression was used to estimate ORs with 95% CIs.Results The mean age was 59.3 years (SD 12.4) and 1379/2480 (55.6%) patients were female. Adequate bowel preparation was achieved in 1787/2480 (72.1%) patients, CCE was completed in 1669/2480 (67.3%), and endoscopic follow-up occurred in 1421/2480 (57.3%). Neither SIMD nor URC was associated with bowel preparation adequacy, CCE completion or follow-up pathway (all p>0.05). Female sex was independently associated with inadequate bowel preparation (OR 1.70, 95% CI 1.42 to 2.04; p<0.001) and CCE incompletion (OR 1.62, 95% CI 1.36 to 1.93; p<0.001). Increasing age was associated with reduced odds of non-endoscopic follow-up (OR 0.99, 95% CI 0.98 to 1.00; p=0.01). Inadequate bowel preparation was strongly associated with subsequent endoscopic investigation (OR 0.18, 95% CI 0.12 to 0.27; p<0.001).Conclusions This is the largest study evaluating socioeconomic deprivation and rurality in CCE. Neither influenced CCE performance or downstream management. Instead, patient factors, including sex, age and bowel preparation quality, were the primary determinants of outcomes. These findings support CCE as an equitable diagnostic modality across diverse populations and support the expansion of community and home-based services.

Source: BMJ Open Gastroenterology

DOI: 10.1136/bmjgast-2026-002386

Authors: Alishah Haider, Ruari Jardine, Jemma Hudson, Angus James Mackintosh Watson

Institution: University of Aberdeen

Language: English

Topic: Colorectal Cancer Screening and Detection

Subfield: Oncology

Field: Medicine

Domain: Health Sciences

SDGs: Good health and well-being, Reduced inequalities

Open Access status: gold

Estimated APC paid: $2,085