Simple pill-on-a-thread test that prevents cancer ‘hiding in plain sight’ must be rolled out, charity warns

A “PILL-on-a-thread” sponge test that could halve oesophageal cancer deaths must be rolled out more widely in Britain, a charity warns.

The capsule sponge test, previously known as cytosponge, releases a sponge to collect cells from the oesophagus as it is retrieved.

It quickly tests for Barrett’s oesophagus — a heartburn-causing condition that can lead to cancer.

Mimi McCord, founder and chairman of the charity Heartburn Cancer UK, said: “Cancer of the oesophagus is a killer that can hide in plain sight.

“People don’t always realise it, but not all heartburn is harmless. While they keep on treating the symptoms, the underlying cause might be killing them.

“We have a test. We know it works. People are dying while we wait to make it widely available.”

Some 9,200 Brits are diagnosed with oesophageal cancer every year in Britain, with 8,000 dying.

Symptoms include having difficulty swallowing, feeling or being sick, heartburn, acid reflux and indigestion.

Most people do not realise they have a problem until they struggle with swallowing, at which point the disease may be too advanced to treat easily, experts say.

The disease has a five-year survival rate of less than 20 per cent, but this rises to 55 per cent if detected early at stage one.

If a doctor suspects you have the disease, the current test is a gastroscopy — a type of endoscopy that involves sending a camera down your throat. 

Treatments depend on the size and type of oesophageal cancer a patient has, where it is, if it has spread and their general health.

Surgery can be performed if the cancer has not spread and they may also be given chemotherapy, radiation and immunotherapy.

My husband would not have died if we spotted symptoms earlier

Ms McCord set up Heartburn Cancer UK after losing her husband Mike, 47, to oesophageal cancer in 2002.

She was 44, with two young adult children, when Mike, a fit and active 47- year-old Lloyd’s Insurance underwriter, choked on a piece of toast one morning.

He died nine weeks later from the disease that had unknowingly been spreading through his body.

She said: “If I knew then what I know now, Mike would not have died. His death was completely avoidable.

“He had heartburn three or four times a week, and he would pop Rennies ad infinitum. 

“But because we didn’t know any better, it didn’t cross our minds that something could be seriously wrong.”

The charity is calling for the wider adoption of the capsule sponge test, made by Cyted, in order for patients to be diagnosed earlier and given a better chance of survival.

The capsule sponge has become one of the most exciting early detection tools to emerge in recent years

Dr Lyndsy AmblerCancer Research UK

It comes after previous studies found the test can pick up more cases of Barrett’s oesophagus compared with routine GP care.

Researchers at the University of Cambridge said the sponge “could halve the number of deaths from oesophageal cancer every year”.

At the moment, it is offered only to higher risk patients as an alternative to endoscopy as part of NHS pilot schemes.

It is understood they could be rolled out further if the trials yield positive results.

Dr Lyndsy Ambler, senior strategic evidence manager at Cancer Research UK, said: “Around 59 per cent of all oesophageal cancer cases are preventable. 

“Yet endoscopy, the gold standard for diagnosing this cancer, is labour intensive.

“We need better tools and tests to diagnose oesophageal cancer and to identify and monitor people most at risk.

“Backed by funding from Cancer Research UK, the capsule sponge has become one of the most exciting early detection tools to emerge in recent years.

“It’s already making a difference in pilots within the NHS in England, Scotland and Wales to reduce backlogs for endoscopy from the pandemic.”

Cancer Research UK is working with the National Institute for Health and Care Research (NIHR) on the BEST4 trial, which will recruit 120,000 people in a bid to explore if the capsule sponge test can reduce deaths from oesophageal cancer.

“If this trial is successful, it could see the test rolled out more widely across the UK,” Dr Ambler said.

A spokesperson for NHS spending watchdog the National Institute for Health and Care Excellence (Nice), said: “Our guideline committee identified cytosponge as a tool which could benefit the NHS for diagnosing dysplasia and cancer, but the quality of the evidence was not sufficient to support its use at present.

“We are aware of two ongoing trials and are hopeful they could produce the evidence required to fully appraise the clinical and cost effectiveness of this potentially useful tool.”