Guy’s & St Thomas’ NHS Foundation Trust has been selected as part of a national pilot scheme to trial the use of Cytosponge to improve the early diagnosis of oesophageal cancer in patients with low-risk gastrointestinal reflux symptoms. The indication has recently been extended to include surveillance of patients with known Barrett’s oesophagus. Barrett’s oesophagus is much more common in men (4:1) and early diagnosis is associated with better outcomes.
Patients who present in primary care with more than 3 weeks of gastrointestinal reflux symptoms, or those on long term PPI who have not had an endoscopy, should be referred to the Trust by the GP as usual through direct access endoscopy. There is no change to the referral process, as the Trust will triage patients and those who are eligible will be offered Cytosponge as an alternative to endoscopy. If the patient would prefer to undergo Cytosponge please do indicate this on referral from.
Any patients with red flag symptoms are not suitable candidates and should be referred on the 2ww pathway as usual.
The aim of the this pilot is to implement Cytosponge in secondary care for patients who are on a routine referral for endoscopy with acid reflux symptoms or Barrett’s surveillance and evaluate its impact on endoscopy demand, patient outcomes, and value for money.
The pilot is being led by Dr Jason Dunn (Consultant Gastroenterologist and Endoscopy Clinical Lead) and Rosemary Haddou (Sister, Endoscopy Unit) at St Thomas’ Hospital. It is supported by the South East London Cancer Alliance.
More information on Cytosponge is available on the Medtronic website.