Colon capsule endoscopy (CCE) is a noninvasive technique for diagnostic imaging of the colon. It does not require air inflation or sedation and allows minimally invasive and painless colonic evaluation. In contrast, clinical use of CCE is not so clear. Cleanliness of the colon has been reported to be the most important factor for increasing the diagnostic value of CCE. However, taking a large amount of PEG-ELS (polyethylene glycol electrolyte lavage solution) is a burden for the patient. Many papers have been published regarding the accuracy of CCE for detection of colorectal neoplasia. According to Japanese data, the per-patient sensitivity was 94.0% and the per-polyp sensitivity was 86.6% for lesions of ≥6 mm. On the other hand, the Western countries' data also showed good sensitivity of 84-94% for lesions of ≥6 mm. Last year, the results of RCT on the diagnostic sensitivity of CT colonography (CTC) and CCE in FIT-positive individuals were reported. This Spanish study was a single-center RCT and 349 patients were enrolled and randomly assigned to CTC and CCE. Based on the results of this study, there was no difference in per-patient sensitivity to advanced neoplasia, but in per-lesion sensitivity, CCE detected more than CTC. In Japan, The Japanese Association for Capsule Endoscopy (JACE) is working for the clinical use of capsule endoscopy. JACE has launched a training course for diagnosticians using e-learning, aiming to standardize the diagnosis of CCE; however, the annual number of CCEs is less than 1000 in Japan, and they are not being effectively utilized. We are expecting to diagnostic examination for FIT-positive individuals and first line colorectal cancer screening in rural areas by remote diagnosis using a CCE cloud system.