Barrett's esophagus is a condition that can lead
to esophageal cancer in a small number of people. CANCER RESEARCH UK-funded scientists have discovered that a 'sponge
on a string' pill test can identify which people with a condition called
Barrett's esophagus have a low risk of developing esophageal cancer -
sparing them uncomfortable endoscopies.
Researchers from the University of Cambridge gave 468 people who had
Barrett's esophagus a 'sponge on a string' (cytosponge) test.
‘A 'sponge on a string' pill test can identify which people with a condition called Barrett's esophagus have a low risk of developing esophageal cancer - sparing them uncomfortable endoscopies.’
They found that the cytosponge test together with additional
laboratory tests identified that 35% (162) of people with
Barrett's in the study were at a low risk of developing esophageal
The results show that patients with Barrett's could be given a
cytosponge test by their local GP and monitored, to detect which
patients were at low risk of developing cancer, rather than having
regular endoscopies at hospital.
This could help save patients' time, as well as reducing the anxiety and
discomfort of having endoscopy tests. Endoscopies are expensive and
involve putting a camera down the throat to collect a sample of the
cells lining the esophagus for analysis under a microscope.
The cytosponge is a small pill with a string attached that the
patient swallows, which expands into a small sponge when it reaches the
stomach. This is slowly pulled back up the throat using the string,
collecting cells from the esophagus for analysis.
The researchers tested these cells for two specific genetic markers
and changes in the cells that can be used to estimate an individual's
risk of developing esophageal cancer. These results, alongside other
information including age and obesity, were used in a mathematical model
to classify patients' risk levels.
Barrett's esophagus is caused by acid reflux. This can occur when
acid travels back up the food pipe from the stomach causing symptoms
such as heartburn. Cells in the esophagus can then become damaged over
time, leading to Barrett's esophagus. People with the condition are also
monitored for early signs of cancer, which can sometimes be triggered
by cell damage.
Lead researcher Professor Rebecca Fitzgerald, based at the MRC Cancer
Unit at the University of Cambridge, said, "Most people who have
Barrett's esophagus will not go on to develop esophageal cancer, but
at the moment there is no way of identifying who will and who won't. Our
study is the first step in using the cytosponge to answer this
question. We're assessing the cytosponge test in larger trials next year to
understand more about how it can help diagnose esophageal cancer
sooner. Compared with endoscopies performed in hospital, the cytosponge
causes minimal discomfort and is a quick, simple test that can be done
by your GP."
Jessica Kirby, Cancer Research UK's senior health information
manager, said, "It would be good news for patients if the cytosponge
test could be used to replace uncomfortable endoscopies for some people. 12% of people with esophageal cancer survive for at
least 10 years, and part of the reason for the lower survival could be
that the disease is often diagnosed at a late stage. Research like this
helps us to understand more about the disease and could help doctors
better predict who is at risk of esophageal cancer."
The study is published in The Lancet Gastroenterology & Hepatology