A UK trial has introduced a simple sponge-on-a-string test as an alternative to endoscopy for diagnosing a condition linked to oesophageal cancer.
The trial by the NHS will benefit thousands of low-risk patients.
Conducted on 8,500-plus patients, the pilot demonstrated that nearly eight out of ten patients who underwent the capsule sponge test were discharged without needing further invasive procedures.
This freed up valuable endoscopy resources for higher-risk patients and urgent cases of oesophageal cancer.
The procedure involves swallowing a small capsule-shaped device containing a tiny sponge for collecting cell samples. Patients can undergo this quick, sedation-free test during a short appointment.
Traditionally, Barrett’s oesophagus, a precursor to oesophageal cancer, is diagnosed via endoscopy after a GP referral.
However, the sponge-on-a-string test offers a less invasive and efficient alternative.
Feedback from the 350-plus patients who underwent the test was overwhelmingly positive, with 94% reporting mild or no discomfort.
NHS Chief Executive Amanda Pritchard praised the test’s efficiency in improving patient experience and reducing waiting lists.
The NHS piloted the test during the pandemic, addressing service pressures and backlog issues.
Gastro-oesophageal reflux, a common condition, affects many individuals, some of whom may develop Barrett’s oesophagus and, subsequently, cancer.
The pilot evaluation revealed significant cost-effectiveness compared to endoscopy-only methods, saving approximately £400 per patient.
Positive results from the capsule sponge test correlated with a higher prevalence of Barrett’s oesophagus.
Pioneered at 30 hospital sites across England, including Manchester, Plymouth, and London, the test has shown promise in early diagnosis and cost savings.
At East and North Hertfordshire NHS Trust, where the test was first introduced, it has proven beneficial in identifying Barrett’s oesophagus and even early-stage cancers while reducing unnecessary endoscopies and prioritising urgent cases.
Dr Danielle Morris, a consultant gastroenterologist at the Trust, said: ‘Using the capsule sponge test as a diagnosis triage tool has had enormous benefits for patients, avoiding the need for unnecessary gastroscopy in almost seven out of 10 patients and helping to reduce endoscopy waiting lists enabling us to prioritise those who need endoscopy to have it done quickly.
‘A single trained practitioner performs the test in an outpatient setting, so it is very resource-light compared to gastroscopy, and our patients are very supportive of the service – with almost nine in 10 patients preferring the capsule sponge to a gastroscopy.’
Developed by Professor Rebecca Fitzgerald at the University of Cambridge, the capsule sponge test has garnered positive results in the NHS trial, signalling a significant advancement in early cancer detection.
She said: ‘It is fascinating to see the positive results of the NHS England real-world pilot for our capsule-sponge test. This is a major step toward making this simple test more routinely available outside clinical trials. Timely diagnosis is vital for improving outcomes for patients.’
