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'Sponge checks' for oesophageal cancer risk

BBC Report - 10th September 2010 
Surgical treatments for Barrett's oesophagus have been invasive and relatively risky in the past

Swallowing a sponge on a piece of string could help detect a deadly form of cancer, UK experts claim.

Medical Research Council scientists have created the "cytosponge" which collects cells from the stomach.

These cells can be checked for a pre-cancerous condition called Barrett's oesophagus which can affect people with a long history of heartburn.

One in 10 people with the condition will go on to develop oesophageal, or food pipe cancer.

According to figures from the cancer charity, Macmillan, around one or two out of every 200 people in the UK have Barrett's oesophagus.

A few of these will go on to develop cancer (about 1 in 100 each year).

Surgical treatments for Barrett's oesophagus have, in the past, been invasive and relatively risky. But procedures can now be carried out using keyhole surgery.

The ideal testing method uses an endoscope, a long thin tube with a camera on the end. But it is expensive and equipment is limited.

The MRC's study is reported in the British Medical Journal.

The team say the cytosponge could be used in primary care as an inexpensive and easily-administered test.

Bleak prognosis

When the sponge is swallowed, it expands to a three-centimetre mesh in the stomach. It is pulled out after five minutes and the cells it collects can then be analysed in the lab.

The researchers, from the MRC's Cancer Cell Unit in Cambridge, tested the device on 500 patients aged between 50 and 70, who also had endoscopies to check the results.

The sponge detected over 90% of cases of Barrett's oesophagus.

Dr Rebecca Fitzgerald, who led the research, said: "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 20 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 are delighted that this trial has shown that patients find this method acceptable and it is a practical screening option."

The researchers will now carry out more studies into the sponge's effectiveness.

Writing in the BMJ Peter Bampton, associate professor in gastroenterology at Flinders University in Australia, said: "Although larger studies are needed to validate these and other markers, future screening and surveillance for Barrett's oesophagus might use a two-step approach, with endoscopy being reserved to confirm the diagnosis."

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