Can a capsule sponge change how we diagnose oesophageal cancer? – Cancer Research UK

The BEST4 trial, which started this week, will show if a capsule sponge (‘pill-on-a-thread’) test can be used to monitor people at high risk of oesophageal cancer. Ultimately, it could give the NHS a quick and simple way to screen for the disease. Researchers say that would  

Tim Cowper, a 49-year-old brewer from Cambridgeshire, has Barrett’s oesophagus. That means he has abnormal cells in his gullet, or food pipe, which have an increased risk of developing into oesophageal cancer cells.  

It’s still rare for Barrett’s oesophagus to lead to oesophageal cancer, but, thanks to Tim’s diagnosis, his doctors know they need to monitor him for any dangerous changes.

So, at least once every three years, they guide a long tube with a camera on the end (an endoscope) down his throat into his oesophagus and take a sample of his cells (a biopsy).

This kind of test is vital for accurately diagnosing many types of cancer. Tim’s endoscopies could save his life.

That doesn’t make them any easier to endure. 

“It is not pleasant at all,” Tim explains. “Each time I have a thick tube pushed down through my mouth. I can feel every single one of the biopsies taken by the camera.”

Endoscopies take a lot of NHS time, money and effort, too, which can mean long waits for tests. Soon, though, finding and monitoring Barrett’s oesophagus – and, ultimately, screening people for oesophageal cancer – could look and feel more like swallowing a vitamin pill than a snake. Researchers say that the change could halve the number of people who die from oesophageal cancer in the UK every year.

Diagnosing oesophageal cancer earlier

It’s all thanks to the capsule sponge, a pill on a thread and lab test developed and refined by Professor Rebecca Fitzgerald and her team at the Cancer Research UK Cambridge Centre. 

Tim’s the first person to join the multi-million pound BEST4 trial, which we’re funding with the National Institute for Health and Care Research. It’s the final step to seeing if this humble sponge on a string can help prevent oesophageal cancer when used to screen or monitor those most at risk of the disease. 

The trials we’ve already funded have shown that the capsule sponge test is safe and accurate. It’s been piloted for people on endoscopy waiting lists in parts of England, Scotland and Northern Ireland. We’ve even learned it can detect 10 times more cases of Barrett’s oesophagus than standard practice. 

Now we’re on the home straight. If the BEST4 trial is successful, the capsule sponge could become a national screening programme across the NHS, in the same way mammograms are used to screen for breast cancer.   

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