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Letter to the editor regarding: Multicentre, prospective, randomised study comparing the diagnostic yield of colon capsule endoscopy versus CT colonography in a screening population (the TOPAZ study)
  1. Firas Ahmed1,
  2. Cecelia Brewington2,
  3. Kevin Jeffrey Chang3,
  4. Courtney Coursey Moreno4,
  5. Marc Gollub5,
  6. Judy Yee6
  1. 1 Radiology, Columbia University, New York, New York, USA
  2. 2 Radiology, UT Southwestern, Dallas, Texas, USA
  3. 3 Radiology, Boston University Medical Campus, Boston, Massachusetts, USA
  4. 4 Radiology, Emory University, Atlanta, Georgia, USA
  5. 5 Radiology, Memorial Sloan Kettering Cancer Institute, New York, New York, USA
  6. 6 Radiology, Montefiore Hospital and Medical Center, Bronx, New York, USA
  1. Correspondence to Dr Firas Ahmed, Radiology, Columbia University, New York, NY 10032, USA; fsa2101{at}

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In a prospective, multicentre, randomised controlled trial in an average colon cancer risk population, the TOPAZ trial, Dr Cash and colleagues1 report that colon capsule endoscopy (CCE) revealed higher diagnostic yield (defined by finding a colonic polyp ≥6 mm that warrants an optical colonoscopy) and higher sensitivity compared with CT colonography (CTC). Based on these findings, Cash et al 1 advocate the use of CCE as a more accurate/superior diagnostic test among patients who cannot/prefer not to undergo optical colonoscopy.

As abdominal radiologists experienced in CTC and as members of the American College of Radiology’s Colon Cancer Committee, we appreciate the effort by the authors in this clinical trial, but we have comments and concerns about the results, discussion and drawn conclusions:

  • The very low CTC sensitivities reported by Cash et al …

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  • Twitter @Cecelia Brewington,MD,FACR@Brewington_UTSW, @kchang, @JudyYeeMD

  • Contributors MG and JY reviewed the publication and started the group effort to send a letter to the editor. FA reviewed the publication being critiqued in our letter and wrote the manuscript. CB, KJC, CCM, MG and JY reviewed and edited the manuscript. FA implemented the edits and included the references.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Provenance and peer review Not commissioned; externally peer reviewed.