A study looking into screening people who are at risk of Barrett's oesophagus (BEST)

Cancer type:

Oesophageal cancer

Status:

Results

Phase:

Pilot

This study looked at a new screening test for people with a high risk of developing Barrett’s oesophagus.

In Barrett’s oesophagus, there are changes in the normal cells that line the food pipe (oesophagus or gullet). This is caused by acid coming back up the food pipe from the stomach (acid reflux). Over a long period of time, people with Barrett’s oesophagus can develop ulcers or narrowing of the food pipe (oesophageal stricture). There is also a small increase in risk of oesophageal cancer. People with Barrett’s oesophagus usually have an endoscopy every 2 years to check for these conditions.

There is no easy screening test available at the moment to pick up Barrett’s oesophagus. Doctors are concerned that many people may not be identified. People may be diagnosed with Barrett’s oesophagus as a result of an endoscopy and biopsy (tissue sample). But this is quite an invasive test and doctors do not recommend that it is used routinely.

This study recruited people aged 50 to 70 years, who had acid indigestion or heartburn. The aims of this study were to find out the acceptability of the new screening test. And to see how well it worked.

Summary of results

The study team found that the new test was acceptable and screening looked like it would work.

This was a pilot study. It recruited 504 people.

Everyone who took part swallowed a small tablet. There was a small sponge inside the tablet attached to a piece of string. When the tablet dissolved in the stomach, the sponge expanded. The researcher then gently pulled the string, removing the sponge from the stomach. It collected cells from the lining of the food pipe.

Of the 504 people recruited, 501 successfully swallowed the tablet.

3 weeks later everyone had an endoscopy to see if they had Barrett’s oesophagus. Of the 501 people, 15 people had Barrett’s oesophagus with a border of 1 cm or more and 10 people with a border of 2 cm or more.

The team compared the results of the sponge with the results of the endoscopy. They found that the sponge showed

11 of the 15 people whose Barrett’s oesophagus was 1 cm or more
9 of the 10 people whose Barrett’s oesophagus was 2 cm or more

The team asked the people to fill in a questionnaire before swallowing the sponge, a week later and then after 3 months. The questionnaire asked how they felt about having the test done. They reported low levels of anxiety before the test and afterwards.

The study team concluded that the sponge screening test was safe, well accepted and looked like it could work.

We have based this summary on information from the team who ran the trial. The information they sent us has been reviewed by independent specialists (peer reviewed Open a glossary item ) and published in a medical journal. The figures we quote above were provided by the trial team. We have not analysed the data ourselves.