Swallowing a Sponge on a String Could Replace Endoscopy as Pre-Cancer Test

Swallowing a sponge on a string could replace traditional endoscopy as an equally effective but less invasive way of diagnosing a condition that can be a forerunner of esophageal cancer. The results of a Cancer Research UK trial involving more than 1,000 people were presented at the National Cancer Research Institute’s annual conference in Liverpool.

The trial invited more than 600 patients with Barrett’s Esophagus – a condition that can sometimes lead to esophageal cancer – to swallow the Cytosponge and to undergo an endoscopy. Almost 500 more people with symptoms like reflux and persistent heartburn did the same tests. The Cytosponge proved to be a very accurate way of diagnosing Barrett’s Esophagus. More than 94 per cent of people swallowed the sponge and reported no serious side effects. Patients who were not sedated for endoscopy were more likely to rate the Cytosponge as a preferable experience. Lead author Professor Rebecca Fitzgerald, based at the MRC Cancer Unit at the University of Cambridge, said: “The Cytosponge test is safe, acceptable and has very good accuracy for diagnosing Barrett’s Esophagus. It should be considered as an alternative to endoscopy for diagnosing the condition and could possibly be used as a screening test in primary care.”

Barrett’s Esophagus is caused by acid coming back up the food pipe from the stomach – known as acid reflux – which can cause symptoms like indigestion and heartburn. Over time people with these symptoms may develop changes in the cells that line the esophagus. These cells can become cancerous and so patients with Barrett’s Esophagus are tested every couple of years. Barrett’s Esophagus is usually diagnosed by having a biopsy during an endoscopy. This can be uncomfortable and carries some risks – and it’s not always practical for everyone who has symptoms like reflux and heartburn. Esophageal cancer is the thirteenth most common cancer in the UK. Around 5,600 men develop the disease each year compared with 2,750 women. And each year around 5,200 men and 2,460 women die from the disease.

Dr Julie Sharp, Cancer Research UK’s head of health information, said: “These results are very encouraging and it will be good news if such a simple and cheap test can replace endoscopy for Barrett’s esophagus. “Death rates are unacceptably high in esophageal cancer so early diagnosis is vital. Tackling esophageal cancer is a priority for Cancer Research UK and research such as this will help doctors to diagnose people who are at risk quickly and easily.”