A “GAME-CHANGING” 10-minute test for a hard-to-catch cancer that primarily affects men over 50 could be sent out to homes, says the Glasgow surgeon who helped develop it, in an exclusive interview with The Herald.
Scotland is the first country in the world to implement “sponge screening” for oesophageal cancer, which is Scotland’s fifth-biggest cancer killer.
The country is facing a huge backlog of patients waiting for endoscopies, the standard – and invasive – procedure for detecting the disease. According to Professor Grant Fullerton, there are thousands of people on referral lists, some of whom may have curable cancer.
The new alternative “walk-in, walk-out” test is minimally invasive and according to its manufacturers could have huge cost-savings for the NHS.
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Patients swallow a tiny device, the size of a vitamin pill, that is attached to a very thin string. It collects cells along the oesophagus that can then be analysed for changes.
We have thousands of patients waiting for investigations
After seven-and-half minutes, the string is pulled out. Patients can be offered a throat-numbing spray, but the test does not require sedation.
Around 15,000 patients have already been tested and about one in six have been diagnosed with Barrett’s Oesophagus, a condition in which the upper gut becomes damaged by acid reflux.
They are at increased risk of developing oesophageal cancer and it is those patients the test is mainly targeting.
Cancer rates have increased sixfold over the past 20-30 years with about 1,000 cases diagnosed every year in Scotland.
Most of those patients will die, says Prof Fullerton, who is based at Glasgow Royal Infirmary, yet the disease has a 90 per cent survival rate if it is treated at stage one.
The new test has already led to 12 patients being diagnosed and he believes it has the potential to “revolutionise” outcomes.
He said: “It’s a major development, a big game-changer that changes the whole process of how we diagnose upper GI (gastrointestinal) disease, moving away from an invasive endoscopic procedure to a much less invasive technique.
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“We are in a major crisis and in Scotland for endoscopy procedures the train has stopped at the station and hasn’t been moving for a year – so we have got thousands of patients waiting for investigations. This has been a godsend.
“My interest has been in Barrett’s and I’ve been pushing the Government so hard trying to get an early cancer diagnosis because oesophageal has always been the Cinderella in the cancer work.
“It’s such a a deadly cancer and there are hundreds, if not thousands of patients out there, who are waiting for tests who may have curable cancer.
“It’s extremely time-dependent, it’s extremely aggressive.
“This is why we are using a cell collection technology rather than waiting for the resurrection of endoscopies. We would never be able to catch up.
“It’s not my creation but we took this idea in Scotland and adapted it to our needs and have rocket-boosted it.
He added: “The vaccine was a great development – and this has been super-charged too.”
About 15,000 patients have already been tested and Prof Fullerton believes it could eventually be available as a kit for home use, similar to the bowel screening programme.
“My next plan is to get this introduced as a screening tool and it’s conceivable that it could be posted to patients. That’s the way to diagnose things early. The population at risk would be men over 50 with reflux symptoms.
“We’ve never had a technique that could be used as a screening tool.”
He said there was some evidence that the device could also guide clinicians to patients who could be at risk of stomach cancer.
Elizabeth McEwan, 66, was given the all-clear after having procedure at Forth Valley Hospital.
She said: “The device is put at the back of your throat to swallow with a big gulp of water.
“There was no gagging sensation as the string its attached to is tiny. Five minutes later the nurse asked if I was happy with her pulling it back up and if I would like some throat-numbing spray, which I agreed to – it’s like a minty spray which numbs the throat as its pulled back out.”
Professor Rebecca Fitzgerald of the University of Cambridge, who created the device, said: “We’ve trained the nurses now across all the health boards in Scotland who are widely adopting and implementing this test.
"The samples are sent to the laboratories for analysis and the results are sent back to the patients within a couple of weeks.”
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