Advances in diagnosing oesophageal cancer

Marcel Gehrung, CEO and co-founder of Cyted, shares insights into the diagnosis of oesophageal cancer with Med-Tech Innovation to mark Oesophageal Cancer Awareness Month.

In the UK, 9,200 patients are diagnosed with oesophageal cancer, and 8,000 patients die from the condition, every year.

This Oesophageal Cancer Awareness Month, we are reflecting on exciting progress that has been made in recent years and focusing on how we can continue to transform patient outcomes and beat patient waiting lists through earlier and faster detection of cancer.

Early detection holds the key to saving the lives of thousands of patients with oesophageal cancer, enabling treatment to be started at a stage that it is most likely to be successful. 7 in 10 patients are diagnosed with oesophageal cancer at a late stage, of which only around 20% survive for one year or more. When detected at an early, pre-cancerous stage, Barrett’s oesophagus, over 80% of patients survive the year. 

Accelerating and streamlining the diagnostic process is arguably more important than ever following the impact of the COVID-19 pandemic. There are now over 68,000 patients on the waiting list for an upper GI endoscopy in England, of which nearly 40% are waiting over six weeks. To save lives, we must drastically and rapidly reduce these patient wait times, through harnessing the power of novel diagnostics and artificial intelligence (AI) in pathology.

Barrett’s oesophagus, a condition in which the cells lining the oesophagus grow abnormally, is a well-defined precursor of oesophageal cancer. Around 3 to 13% of people with Barrett’s oesophagus develop a type of oesophageal cancer called oesophageal adenocarcinoma in their lifetime – 11 times more than the average person. Yet, it often goes undiagnosed as its main symptoms, heartburn, and indigestion, are common of several conditions.

To improve the early detection, and consequent survival of oesophageal cancer, there has been a focus on improving the detection of Barrett’s oesophagus, including the development of the Cytosponge test.

The Cytosponge test is a novel diagnostic test that uses a ‘sponge-on-a-string’ device to collect cells from the oesophagus, which are then sent to the Cyted laboratory for digital diagnostic processing and analysis. The powerful data platform identifies the patients who are most at risk of Barrett’s oesophagus or early oesophageal cancer, so they can subsequently be prioritised for endoscopic confirmation and subsequent treatment, supporting pathologists to deliver greater impact, more effectively.

Patients with acid reflux that were offered the Cytosponge test are 10-times more likely to have their Barrett’s oesophagus detected than patients who had received the standard care procedure, which is being offered an endoscopy if required by their GP.

Since late 2020, over 6,000 Cytosponge procedures have been carried out in the UK. This results in a significant number of patients being diverted from endoscopy waiting lists. Reducing the number of patients requiring endoscopy will also contribute to an improvement in the patient experience and cut costs for the health system. The Cytosponge test can be delivered in minutes by a trained nurse, is minimally invasive and is a cheaper procedure when compared with endoscopy.

In addition, innovative diagnostic tests that can be delivered outside of hospitals have an important role to play in tackling health inequalities that exist in society. Through community diagnostic hubs, there is the potential to reach patients that typically experience worse health outcomes.

Advances in digital pathology and AI have started a new revolution in the diagnosis of oesophageal cancer and beyond. Through these advancements, we have the potential to support the NHS in tackling the growing backlog of patients waiting for endoscopy, and ensure patients receive their diagnosis as soon as possible so they can start potentially life-saving cancer treatment.

As we support the NHS in driving its recovery post-COVID-19, we must remain focused on supporting pathologists to deliver maximum impact for patients. Our technologies are not limited to just oesophageal cancer, and in the future, we have the potential to apply this to a range of other cancers and diseases.