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GP surgeries to trial ‘sponge’ test for precursor of upper GI cancer

GP practices across the UK are being asked to try out a new, non-invasive test for Barrett’s oesophagus in people with acid-reflux symptoms, to help improve early detection of oesophageal cancer.

The practices will use the ‘Cytosponge’ test to look for changes in the oesophageal cells that occur in Barrett’s oesophagus, which in turn increases the likelihood of subsequently developing oesophageal cancer.

The test takes about five minutes and involves the patient swallowing a capsule that contains a sponge inside, attached to a string. The capsule dissolves when it reaches the stomach and the sponge is then pulled out – collecting cells from the lining of the oesophagus as it passes through.

The approach could be rolled out nationally to become part of GPs’ routine practice, if the test proves cost-effective and acceptable to patients, Cancer Research UK said.

The charity is funding the trial and is looking for up to 150 GP practices to sign up to offer the Cytosponge test to people over 50 who are on long-term acid-suppressant medication.

The hope is to recruit nearly 9,000 patients for the randomised trial – half of whom will be care for as normal while the other half will be offered the Cytosponge test as well. Patients with a positive Cytosponge test result will be referred for endoscopy to confirm the results and at the end of the trial, 10% of patients in both arms of the trial will be offered an endoscopy.

Lead investigator Professor Rebecca Fitzgerald, from the MRC Cancer Unit, University of Cambridge, said: ‘We’re excited to see this being tried out in GP surgeries. It’s a safe way to test for Barrett’s oesophagus and we hope that this will make it easier for GPs to identify patients who have an increased risk of developing oesophageal cancer without having to refer them to hospital.’

Dr Richard Roope, Cancer Research UK’s GP expert, said: ‘GPs are always looking for new ways to ensure patients receive the best possible care. Trialling a new, less invasive technique to test for Barrett’s oesophagus means that many patients each year could be saved from experiencing an endoscopy which can be uncomfortable.

‘Around three in every 100 people with Barrett’s oesophagus go on to develop oesophageal cancer so techniques that help us to prevent or diagnose the disease earlier are vital.’

It comes as NHS England is trialling a range of approaches to diagnosing cancer earlier, including getting patients to self-refer for chest X-rays, lowering the bar for the level of suspicion at which GPs an refer people for cancer investigations, giving GPs direct access to diagnostic tests and the introduction of ‘one-stop shop’ type multidiscipilinary diagnostic centres for people with vague symptoms to have lots of tests done at the same time.



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