Innovative Capsule Sponge May Reduce the Need for Invasive Endoscopies in Esophageal Cancer Monitoring

Recent research from the University of Cambridge, Addenbrooke's Hospital, and Queen Mary University of London suggests that a less invasive, capsule-based test could replace traditional endoscopies for half of patients undergoing surveillance for Barrett's esophagus, a precursor to esophageal cancer. Published in The Lancet, the study highlights how the capsule sponge test, which involves swallowing a pill attached to a thread that releases a sponge in the stomach, can be used to collect esophageal cell samples by simply pulling it back up. This method is easier to administer, potentially performed by nurses at GP practices, and reduces the strain on NHS resources.

Esophageal cancer is notably challenging to treat, with survival rates below 20% five years post-diagnosis, and its incidence has quadrupled since the 1970s. Barrett's esophagus, characterized by abnormal cell changes in the esophagus lining, is a key risk factor. It often is diagnosed through invasive endoscopy, which can be uncomfortable and may have variability in detection accuracy depending on the examiner's skill.

The new research focuses on using the capsule sponge not only for detecting Barrett's esophagus but also for stratifying patients based on their risk of progression to cancer. In a UK-wide study involving 910 patients, the capsule test effectively categorized patients into high, moderate, and low-risk groups by identifying markers such as abnormal p53 protein and atypia. Remarkably, over 54% of patients fell into the low-risk group, with a minimal percentage showing signs of high-grade dysplasia during follow-up.

Lead researcher Dr. W. Keith Tan emphasized that the capsule sponge could be as accurate as traditional endoscopy for risk assessment while being more accessible and cost-effective. Professor Rebecca Fitzgerald noted that this innovation could significantly improve monitoring standards, especially given the current delays and discomfort associated with endoscopic procedures.

Supporting these findings, Professor Peter Sasieni from Cancer Research UK stated that the simplicity of the capsule sponge allows for risk-based surveillance, potentially sparing many patients from unnecessary invasive tests. The findings suggest that the capsule sponge could serve as a primary screening and monitoring tool, improving early detection rates and treatment outcomes.

This breakthrough offers promising prospects for enhancing early diagnosis and reducing discomfort for patients while easing the burden on healthcare systems. The research team envisions wider adoption of this technology as a key step toward more personalized and less invasive management of Barrett's esophagus and esophageal cancer risk. Source: https://medicalxpress.com/news/2025-06-pill-thread-endoscopies-patients-esophageal.html