Colon capsule endoscopy in Ireland: analysis of the Irish Capsule Registry (ICaRe)

Objectives To evaluate the real-world technical performance, diagnostic yield and downstream endoscopy rates of colon capsule endoscopy (CCE) in Ireland and identify clinical factors associated with these outcomes. Methods This multicentre observational study analysed prospective data from the Irish Capsule Registry. Procedures from six centres between October 2023 and February 2026 were included. Outcomes included capsule transit, bowel cleansing adequacy, complete examination (complete transit with adequate cleansing), diagnostic yield and referral for lower gastrointestinal endoscopy. Multivariable logistic regression identified predictors of key outcomes. Results 920 CCE examinations were analysed (mean age 54.9±15.4 years; 61.4% female). Complete capsule transit was achieved in 81.1%, adequate bowel cleansing in 82.6% and complete examination in 70.1%. Clinically significant findings were detected in 38.7% of examinations, most commonly significant colonic polyps (≥3 polyps or any ≥6 mm). Lower gastrointestinal endoscopy was recommended in 38.0% of cases. Increasing age was independently associated with higher diagnostic yield (OR 1.01 per year, p=0.007), without affecting technical outcomes or endoscopy rates. Clinical indication influenced downstream endoscopy rates, highest in surveillance populations (50.4%) and lowest in inflammatory bowel disease assessment (22.2%). Incomplete examinations had substantially higher downstream endoscopy rates (56.2% vs 30.3%). Conclusions CCE demonstrated good technical performance and diagnostic yield in routine Irish practice, with downstream endoscopy rates consistent with a clinician-selected population. Outcomes varied by clinical indication, and older age was associated with higher diagnostic yield without adverse effects on performance. These findings emphasise patient selection, favouring lower-risk populations, while supporting use across age groups.