Video Capsule Endoscopy: What Is the Role in Surveillance of Hereditary Colon Cancer Syndromes?

Video capsule endoscopy (VCE) is a new technology which has proven to be effective for screening of the entire small bowel in those hereditary colon cancer-prone disorders that predispose to small bowel polyps and small bowel cancer (SBC). VCE appears to be superior to both barium studies and push enteroscopy for diagnosis of small bowel lesions in these disorders. However, in the interest of maximum benefit to our high-risk patients, the endoscopist must fully understand the natural history of hereditary colorectal cancer (CRC) disorders and their molecular genetics. It is in this realm that a comprehensive cancer family history will be of great benefit in allowing greater certainty in diagnosis and, in particular, in ability to focus on the specific germline mutation that may help to confirm the hereditary CRC syndrome of concern.