New capsule sponge test for Barrett’s oesophagus

A new capsule sponge test for Barrett’s oesophagus, which was trialled by the NHS could reduce the need for invasive endoscopy in thousands of low-risk patients.

The pilot tested over 8,500 patients and showed almost eight out of 10 patients were discharged without the need for further testing, freeing up endoscopy capacity for higher risk patients and those referred for urgent tests for oesophageal cancer.

The test involves patients swallowing a small capsule-shaped device which contains a tiny sponge that collects cell samples for analysis before being extracted via a string attached to the sponge.

Barrett’s oesophagus – a condition affecting the food pipe which can go on to cause oesophageal cancer in some patients – is usually diagnosed or ruled out via endoscopy (a camera test of the food pipe) following a GP referral to a gastroenterologist or other specialist practitioner who can carry out the procedure.

Almost nine in 10 patients preferring the capsule sponge to a gastroscopy

Dr Danielle Morris, a consultant gastroenterologist at the trust, said: “Using the capsule sponge test as a diagnosis triage tool has had huge 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 really need endoscopy to have it done quickly.

“The test is performed by a single trained practitioner 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.”

The test, which was developed by Professor Rebecca Fitzgerald, director of the early cancer institute at the University of Cambridge, was also highly cost effective compared to using endoscopy-only for diagnosing patients – saving around £400 per patient.

The NHS began piloting the test during the pandemic when there was increased pressure on services and a growing backlog for endoscopy. It was launched at 30 hospital sites across 17 areas in England including Manchester, Plymouth, London, Kent and Cumbria.