Flinders University team looks at screening for Barrett’s oesophagus

A three-step plan, which includes a tiny pill swallowed in a GP’s surgery, could be a less invasive way to screen people and prevent deaths from oesophageal cancer, Australian researchers have found.

A new screening method for the potentially deadly Barrett’s oesophagus could help combat the prevalent condition.

Australian researchers are investigating screening for a potentially deadly condition called Barrett’s oesophagus which affects about four per cent of Australians and can cause cancer.

The three-step plan, which includes a tiny pill swallowed in a GP’s surgery, could be a less invasive and cheaper way to screen people and prevent deaths from oesophageal cancer.

Barrett’s oesophagus is a condition where the lining along the oesophagus (food pipe) becomes damaged from prolonged exposure to stomach acid, also known as reflux. Left untreated it can develop into oesophageal cancer.

While usually treatable early, many people are unaware they have it because the symptoms are similar to heartburn.

It is more common in men over the age of 40 and triggers include poor diet, drinking and smoking as well as obesity and genetics. Men are also up to nine times more likely to develop oesophageal cancer from the condition.

Barrett’s oesophagus is caused by prolonged exposure to stomach acid and can develop into oesophageal cancer. Picture: Supplied

The researchers, from Flinders University in South Australia, now want to run a pilot study of the pill, called Cytosponge, to see if it can help screen for the disease.

They published a study that looked at the economic modelling for screening and found with better ways of identifying and treating Barrett’s oesophagus it will help reduce the risk of it developing into oesophageal cancer and increase patient survival.

The researchers said while the device was not yet available in Australia, a UK trial of more than 10,000 people was showing promising results.

Senior researcher David Watson said it does not need any sedation, is performed in less than 10 minutes and could be rolled out through general practice.

“Not every patient will need it. First they would fill out a specific AI questionnaire to check their risk,” Professor Watson said. “That’s basically free and can be built into the screening.”

The next stage would be for those at risk to swallow the pill which has a string on the end.

“It contains a ball of abrasive plastic that looks a bit like steel wool and it expands once the gel dissolves in the stomach,” Professor Watson said. “Then you pull it back up and it scrapes some cells off the lining of the oesophagus that can be looked at.”

Professor Watson, who is also head of the University Department of Surgery at Flinders Medical Centre, said symptoms of reflux can usually be controlled with medication.

“If your medications are not controlling your symptoms then you should certainly be seeing a GP and possibly getting a referral to a specialist which is probably going to be a gastroenterologist,” he said.

Researchers say many people are unaware they have Barrett’s oesophagus because the symptoms can be confused with heartburn.

The study’s lead author Norma Bulamu from the College of Medicine and Public Health said there was no screening for Barrett’s oesophagus in Australia.

“Its identification is opportunistic, and the (existing) test is limited to an endoscopy, which is not only an invasive procedure for patients, but also costly to the health system,” Dr Bulamu said.

Dr Bulamu said the team, that also included Dr Tomonori Aoki, looked at economic modelling and found this multi-step strategy to identify Barrett’s’ oesophagus could start with risk assessment through a free questionnaire, followed by less-invasive devices such as the Cytosponge and end with an endoscopy where necessary.

Professor Watson said the study also evaluated serum or blood-based screening tools, but these were found to add substantial costs without significantly improving diagnostic accuracy.

The team’s research was published in the Journal of Gastroenterology and Hepatology,

Originally published as Flinders University team looks at screening for Barrett’s oesophagus