Sponge on a string reduces the long wait for a cancer diagnostic test

A “sponge on a string” used to identify a precursor to one of Britain’s deadliest cancers will help reduce the long delays faced by patients needing a vital diagnostic test.

An NHS trial of the innovative “cytosponge” has found that almost eight out of 10 people assessed using the method do not subsequently have to go on the waiting list for an endoscopy.

About 8,500 patients in England have been tested so far using the cytosponge, a tablet-sized capsule that, when washed down with a glass of water, expands in the stomach. It is then pulled out using the attached wire, allowing the collected cells to be analyzed to see if someone has done so Barrett’s esophaguswhich caused risk of developing esophageal cancer.

Esophageal cancer – cancer of the esophagus – is on the rise and is closely linked to risk factors such as poor diet, smoking, alcohol consumption and having a hiatus hernia.

NHS England’s review of 2,550 of those 8,500 patients found that 78% of them did not have Barrett’s oesophagus and could be treated by their GP in the future instead of having an endoscopy.

The test, which involves placing a tiny camera inside a person’s body, is an important way to diagnose some cancers, such as colon and stomach cancer.

Only 22% of those tested with the sponge and found to be at higher risk of the condition required an endoscopy, which in turn gives patients at increased risk of cancer quicker access to an endoscopy.

Experts say the new method could reduce the number of people diagnosed too late with esophageal cancer, the fourth biggest cancer killer in men and the seventh biggest in women.

Around 9,300 people a year in Britain are diagnosed with the disease and 8,000 – 22 a day – die from it, according to Cancer Research UK (CRUK). Only 12% of diagnosed patients survive ten years.

NHS England has been carrying out the sponge test in 30 hospitals since 2021. It has attracted a lot of interest because it takes much less time than an endoscopy, is much less invasive and quicker to access, and is £300 cheaper per time to perform on the NHS.

“Thousands of people have now benefited from this incredibly efficient test on the NHS. Although the sponge on a string is small in size, it can make a big difference to patients,” said Amanda Pritchard, CEO of NHS England.

Lister Hospital in Stevenage is one of 30 hospitals carrying out the test.

Danielle Morris, a gastroenterologist at the hospital, said 670 of the first 1,000 patients who underwent the sponge test did not need gastroscopy – the type of endoscopy traditionally used to check Barrett’s esophagus.

She said: “This is good for patients because those who did need an endoscopy received it more quickly, as a large number of patients who did not need to be on the routine waiting list were removed from it.”

It has helped the Lister reduce waiting times for endoscopy, which were many months long during Covid, to six to eight weeks, she added.

Patients who undergo the sponge test will receive it within three weeks of being referred by a GP and will receive the results two to three weeks later.

In England, 99% of patients should undergo an endoscopy within six weeks of referral. However, 35% of the 179,000 people on the endoscopy waiting list in December were 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 review adds to the evidence showing that it helps the NHS free up endoscopy capacity and could lead to improvements in reducing late diagnosis of oesophageal cancer.”