Influence of deprivation and rurality on colon capsule endoscopy outcomes: a retrospective analysis of the ScotCap registry
- 1The School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
- 2Aberdeen Centre for Evaluation, University of Aberdeen, Aberdeen, UK
- 3University of Aberdeen, Aberdeen, UK
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.
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BibTeX
@article{haider2026influence,
title = {{Influence of deprivation and rurality on colon capsule endoscopy outcomes: a retrospective analysis of the ScotCap registry}},
author = {Alishah Haider and Ruari Jardine and Jemma Hudson and Angus James Mackintosh Watson},
journal = {BMJ Open Gastroenterology},
year = {2026},
month = nov,
doi = {10.1136/bmjgast-2026-002386},
url = {https://doi.org/10.1136/bmjgast-2026-002386},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Influence of deprivation and rurality on colon capsule endoscopy outcomes: a retrospective analysis of the ScotCap registry
AU - Alishah Haider
AU - Ruari Jardine
AU - Jemma Hudson
AU - Angus James Mackintosh Watson
PY - 2026
DA - 2026/11/03
JO - BMJ Open Gastroenterology
DO - 10.1136/bmjgast-2026-002386
UR - https://doi.org/10.1136/bmjgast-2026-002386
AB - 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.
SN - 2054-4774
ER -