‘Pill on a string’ to transform oesophageal cancer diagnosis

Cytosponge (credit: Cancer Research UK)

The incidence of oesophageal adenocarcinoma (OAC) has increased sixfold since the 1990s, and only 13% of these patients live more than five years. However, at least 4,500 of the 9,000 cases of OAC diagnosed each year in the UK could be prevented by detection of Barrett’s oesophagus – a precancerous lesion caused by gastro-oesophageal reflux (heartburn) that can be cured with endoscopic treatment.

Cambridge researchers conceived, developed and validated at population-scale Cytosponge®-TFF3: the first non-endoscopic triage test for Barrett’s oesophagus that can be deployed in an office-based setting in primary or secondary care.

Randomised trial evidence has shown that Cytosponge-TFF3 increases detection of Barrett’s oesophagus tenfold over a year compared with standard care. Furthermore, the probability that Cytosponge-TFF3 was cost -effective was over 90%, at the UK National Institute for Health and Clinical Excellence willingness-to-pay threshold of £20,000 per QALY.

The Cytosponge cell collection device is approved by the US Food and Drug Administration and is also CE approved. It is licensed to the US company Medtronic.

Cytosponge – Early detection for oesophageal cancer

A University of Cambridge spin-out, Cyted Ltd, is providing the laboratory processing, analysis and reporting of Cytosponge in the UK and artificial intelligence algorithms will enable implementation at scale.

Due to the COVID-19 effects on endoscopy backlogs, Cytosponge-TFF3 has been commissioned by some UK National Health Service (NHS) Trusts (e.g. University College London Hospitals), is implemented across 10/11 NHS Scotland Health Boards and a pilot implementation is ongoing in NHS England.

“If I hadn’t taken the Cytosponge test, I would now be walking around with cancer… the fact I am clear of cancer is fantastic… I believe this trial saved my life.”

– Patient feedback after the Cytosponge-TFF3 test