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The team, led by Dr Rebecca Fitzgerald at the MRC Cancer Cell Unit in Cambridge, has proven that the Cytosponge provides an accurate and less uncomfortable method of diagnosis. MRC researchers hope it could become the first screening option administered by nurses in a GP clinic. The current method of diagnosis, endoscopy, normally requires attending hospital and sedation.
In the study, published today in the British Medical Journal, the patients were diagnosed by swallowing a capsule with a string attached and taking a drink of water. The device then dissolved in the stomach to expand into a sponge-like mesh 3cm wide. Five minutes later, the expanded Cytosponge was removed through the mouth by pulling on the string, collecting cells for analysis en route. These cells were stained with a molecular marker or flag which allowed the researchers to identify Barrett's cells, if present, under the microscope.
Barrett's oesophagus is an alteration of the oesophageal tissue and can occur in people who have had heartburn over a considerable period of time. It is the main risk factor for oesophageal cancer. In the UK at least 375,000 people are estimated to develop Barrett's oesophagus each year. Ten per cent of these patients will then go on to develop oesophageal cancer. Unfortunately, once cancer is diagnosed, there is only a one in ten chance of survival after five years.
The study assessed 500 patients aged between 50 and 70. The researchers tested whether the device gave an accurate diagnosis and could be used by patients as a practical screening method. Virtually all patients (99 per cent) were able to swallow the device without a problem. The test uncovered that 3 per cent had Barrett's oesophagus.
Dr Rebecca Fitzgerald from the MRC Cancer Cell Unit is thrilled by the results: "The UK has the highest level of this form of oesophageal cancer in Europe and cases in the Western world have risen rapidly over the past twenty years. As oesophageal cancer carries such a bleak prognosis for patients, it has become more and more obvious that a safe, minimally invasive and easily administered method of diagnosis for Barrett's oesophagus is urgently needed.
We developed the Cytosponge coupled with a molecular test at the MRC Cancer Cell Unit as a direct response to this challenge. We are delighted that this trial has shown that patients find this method acceptable and it is a practical screening option. We look forward to undertaking further studies and establishing this as the recommended screening method for patients."
This was work was also supported by funding from Medical Research Council Technology (MRCT), an exclusive agent of the MRC that helps to translate cutting edge scientific discoveries into commercial products. Driving discoveries made by MRC-funded researchers into new and better treatments for patients is a crucial part of the MRC's five year strategy. .
Oesophageal cancer screening has been identified as a key priority in the Chief Medical Officer's 2007 Annual Report and a larger scale, multi-centre trial has been awarded funding to follow-up these findings.
