A “sponge on a string” used to identify a precursor to one of Britain’s deadliest cancers is helping to reduce the long delays faced by patients who need an essential diagnostic test.
An NHS trial of the innovative “cytosponge” found that nearly eight in 10 people assessed with the method did not then have to join the waiting list for an endoscopy.
About 8,500 patients in England have so far been tested with the cytosponge, a capsule the size of a tablet which, when washed down with a glass of water, expands in the stomach. It is then pulled out using the attached thread so that the cells it has collected can be analyzed to see if someone Barrett’s esophagusthe risk of developing esophageal cancer.
Esophageal cancer – cancer of the food pipe – is on the rise and is now associated with risk factors such as poor diet, smoking, alcohol consumption and a hiatal hernia.
NHS England’s evaluation of 2,550 of those 8,500 patients found that 78% of them did not have Barrett’s esophagus and could be managed by their GP in future rather than having an endoscopy.
The test, which involves inserting a small camera into someone’s body, is a key way to diagnose a number of cancers, such as colon and stomach cancer.
Only 22% of those tested with the sponge and found to be at higher risk for the condition had to undergo an endoscopy, which in turn gives higher-risk suspected cancer patients quicker access to one.
Experts say the new method could reduce the number of people diagnosed late with esophageal cancer, which is the fourth biggest cancer killer in men and seventh biggest in women.
Around 9,300 people a year in the UK are diagnosed with the disease and 8,000 – 22 a day – die from it, said Cancer Research UK (CRUK). Only 12% of those diagnosed survive for 10 years.
NHS England has undertaken the sponge test in 30 hospitals since 2021. It has generated a lot of interest because it takes much less time than an endoscopy, is much less invasive and quicker to access, and is £300 a time cheaper for the NHS to carry out.
“Thousands of people have now benefited from this incredibly effective test on the NHS. While the sponge on a string is small in size, it can make a big difference to patients,” said Amanda Pritchard, NHS England chief executive.
The Lister Hospital in Stevenage is one of 30 hospitals piloting the trial.
Danielle Morris, a consultant gastroenterologist at the hospital, said 670 of the first 1,000 patients who had the sponge test did not need a gastroscopy – the type of endoscopy traditionally used to look at Barrett’s esophagus.
She said: “It’s good for patients because those who needed an endoscopy got it faster because a large number of patients who didn’t need to be on the routine waiting list were removed from it.”
This has helped the Lister reduce endoscopy waiting times, which were many months long during Covid, to between six and eight weeks, she added.
Patients who undergo the sponge test receive it within three weeks of being referred by a GP and get their results two or three weeks later.
In England, 99% of patients undergo an endoscopy within six weeks of referral. However, 35% of the 179,000 people on the endoscopy waiting list in December were already waiting longer than that, according to analysis of NHS data by CRUK, which helped fund the sponge’s development.
Dr Lyndsy Ambler, the charity’s senior strategic evidence manager, said: “The capsule sponge test has become one of the most exciting early detection tools to emerge in recent years.
“This evaluation adds to the evidence showing that it helps the NHS free up endoscopy capacity and can lead to improvements in reducing late diagnosis of oesophageal cancer.”
