Capsule sponge technologies for the detection of Barrett’s oesophagus and early stage oesophageal cancer

What were we asked to look at?

The Scottish Health Technologies Group (SHTG) was asked to evaluate the use of capsule sponge devices to detect Barrett’s oesophagus and early-stage oesophageal cancer. We considered clinical effectiveness, cost effectiveness, safety, and the patient experience.

Why is this important?

The majority of people diagnosed with oesophageal cancer in Scotland present with advanced disease. Early detection of oesophageal cancer is associated with improved survival. Patients with early-stage oesophageal cancer have a 5-year survival rate of approximately 95% compared with 5–40% in patients with advanced disease at diagnosis.

Chronic gastro-oesophageal reflux (GORD) and Barrett’s oesophagus are known risk factors for developing oesophageal cancer. People with chronic reflux often undergo endoscopies to detect Barrett’s oesophagus. People with Barrett’s oesophagus undergo routine surveillance endoscopies to detect early signs of cancer. Most people with chronic reflux or Barrett’s oesophagus do not progress to having cancer. Providing endoscopies for these two patient groups contributes to a high demand on endoscopy services.

During the COVID-19 pandemic many endoscopies were cancelled, resulting in long patient waiting lists. The Scottish Government recognised the potential for capsule sponge technologies to improve patient access to cancer diagnosis and reduce endoscopy waiting times.