A British hospital is the first in the world to use a ‘sponge on a string’ to detect oesophageal cancer in a Covid-safe way.
It allows health workers to collect cell samples from the food pipe without the need for an endoscopy, biopsy or sedation.
Endoscopies, which involve passing a thin tube containing a camera and light into the body, were suspended during the pandemic because they can cause the virus to be sprayed into the air.
But University College London Hospital continued to assess patients by switching to the pioneering Cytosponge.
It will now be the hospital’s usual standard of care after proving quicker, cheaper and more effective at detecting disease.
Endoscopies, which involve passing a thin tube containing a camera and light into the body, were suspended during the pandemic because they can cause the virus to be sprayed into the air. But University College London Hospital continued to assess patients by switching to the pioneering Cytosponge
NHS England and NHS Scotland are looking to offer it nationwide later this year.
Cytosponge is the size of a multivitamin tablet that can be easily swallowed without the need for sedation or a specialised endoscopy suite.
It is given to patients as a pill attached to a string, which they hold while swallowing with water.
Once in the stomach, the pill dissolves within seven to eight minutes, releasing the sponge, which is then gently pulled out by a nurse.
It collects cells from along the entire length of the oesophagus, or gullet, with 365-degree coverage, as it is removed.
Cytosponge does this without using biopsy – where tissue is cut away to be tested.
UCLH is the first hospital in the world to use the device outside of academic research and detected two cancer cases in its first month.
These patients were classified as high risk and brought back for further tests and life-saving surgery to remove cancerous cells.
Check-ups with the sponge costs a quarter of the price of endoscopy and can be done in primary care by a nurse, without the need for a dedicated room.
Sally Thorpe, a clinical nurse specialist, said: ‘Cytosponge can be performed in under 10 minutes, from instructing the patient to cell collection.
‘In contrast, an endoscopy of the oesophagus with biopsy can take up to an hour.
‘It is very simple to use and well tolerated by patients, the only side effect is a mild sore throat.’ The sponge is used to monitor patients with Barrett’s Oesophagus, a condition in which the lining of the oesophagus becomes inflamed.
They may develop lesions, or precancerous cells, which can lead to oesophageal cancer.
Oesophageal cancer has a five-year survival rate of less than 20 per cent but this rises to 90 per cent if detected early, at stage one.
People with Barrett’s Oesophagus are invited for ‘surveillance’ appointments every three months to five years, depending on the severity of their condition.
Trust chief executive Professor Marcel Levi said: ‘UCLH has adapted quickly to implement screening with Cytosponge.
‘We are so proud of the innovative thinking of the team who have worked together to modify care for our Barrett’s Oesophagus patients in such a clever way.
‘It is cost and resource-efficient compared to routine endoscopy, and non-aerosol generating which is helpful to manage risk during the Covid-19 pandemic.’ Conventional surveillance with endoscopy is invasive and increases the risk of side effects such as infection or perforation. The need for sedation may carry further complications.
The procedure is also expensive, costing over £1,500 a time.
There are around 9,200 new oesophageal cancer cases in the UK every year, with 8,000 deaths.
It is estimated that there are between 375,000 and one million people in the UK who have Barrett’s Oesophagus, with up to 13 per 100,000 developing oesophageal cancer in their lifetime.