Cytosponge

Background

We are always looking for innovative ways to provide the best possible care for the people of Lancashire and South Cumbria.

New developments such as Cytosponge, mean that we can offer investigations for a range of conditions in a much less invasive way, and sometimes wthout the need to attend a hospital.

By utilising these new techniques, we can help to address the inevitable waiting lists for endoscopy procedures that have arisen during the COVID-19 pandemic.

Many patients who would normally be followed up for Barrett’s oesophagus or investigated for cancer using traditional endoscopy may now be offered this alternative investigation.

This has been made possible by our collaborative working with other agencies such as the Innovation Agency.

What is Cytosponge?

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Cytosponge is a new diagnostic test being introduced by NHS England to identify important oesophageal conditions such as Barrett’s oesophagus.

Identifying cell changes in screening is important to ensure conditions such as Barrett’s do not progress to become oesophageal cancer. Screening allows cell changes to be identified and simple, curative treatment to be offered.

The Cytosponge is a small capsule which is attached to a fine string.

After swallowing, the capsule coating (vegetarian gelatin) dissolves in the stomach to release a small brush which, when removed allows cell collection from the lining of the oesophagus (gullet or food-pipe). These cells are then analysed for abnormalities.

The test itself takes around 30 minutes and has been found in several studies to be safe, well-tolerated and effective.

Why is it used?

It's common to suffer from heartburn and acid reflux, but this can occasionally lead to changes in the normal cells within your oesophagus (gullet) - known as Barrett's oesophagus.

Very occasionally, Barrett's oesophagus may develop pre-cancerous or cancerous changes which may lead to oesophageal cancer (cancer of the gullet).

Early detection of cell changes (dysplasia) in Barrett's oesophagus can make treatment much easier, and have less of an impact on the patient.

A Cytosponge test allows your doctor to investigate any symptoms and helps to manage them.

During the pandemic, NHS England and NHS Scotland have evaluated the model and impact of delivering the Cytosponge in secondary care, testing over 4000 patients across 40 hospitals since September 2020.

Based on real-world evidence gathered so far, the Cytosponge has a positive pick-up rate of 15-20% and diverts ~75% of routine reflux referrals and Barrett’s surveillance patients from endoscopy waiting lists.

Within Lancashire and South Cumbria Cancer Alliance, Lancashire Teaching Foundation Trusts is participating within the National Trial.

Benefits

One major benefit in the recovery period from COVID-19 is that the procedure is minimally-aerosol generating, reducing the risk to the patient and healthcare professional alike.

It can be delivered outside an endoscopy suite in a separate clinical room, including in the longer term in primary care.

There are benefits to the patient in terms of the ease of the procedure in comparison to endoscopy, and that it can be delivered for some patients at an accessible venue outside the hospital environment.

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