New low-cost test for oesophageal cancer

25 January 2019

A team of researchers at Johns Hopkins University School of Medicine have created a test known as the EsophaCap, which could provide a simple and inexpensive screening method for oesophageal cancer. The findings were published in the journal Clinical Cancer Research.

Oesophageal cancer causes more than 400,000 deaths around the world annually and there are nearly half a million new cases each year. Currently, there is not an efficient or reliable method of screening for the disease, which means that patients are often diagnosed too late to be provided with effective treatment. Both endoscopy and biopsy can be used but are expensive, inaccurate and reliant on random tissue samples, rather than material from the whole oesophagus lining.  

EsophaCap works by using specific genetic biomarkers to detect particular changes in the cells that line the inside of the oesophagus. It takes around a minute for the capsule to go down the oesophagus and into the stomach, where the capsule’s gelatine coating begins to dissolve.

When the gelatine has melted, a 2 cm polyurethane sponge, which is attached to a string, appears. Most of the string is still hanging out of the patient’s mouth. The clinician administering the test then gently pulls the string to remove the sponge.

On its way back up, the sponge comes into contact with the entirety of the oesophagus and collects genetic material along its way. This provides valuable information regarding the patient’s oesophageal health. The sponge is then sent to a company that performs simple genetic tests to determine the patient’s risk of developing oesophageal cancer.

“Early detection is the whole ballgame when it comes to oesophageal cancer,” said researcher Stephen Meltzer. “Patients have a much better chance to treat it, or even prevent it if they know their risk. We believe this little sponge can bring easy and inexpensive screening to people around the world.”

The five year survival rate for patients with the diseases is cancer 43%. When it spreads locally, the rate falls to 23% and when it spreads to distant parts of the body, this rate drops to only 5%.

Researchers administered EsophaCap to 94 people over the course of the study. 85% of participants were able to swallow the capsule and there was a 100% success rate of sponge retrieval. There were no reports of adverse events, such as bleeding, pain, trauma or other adverse reactions to the test.



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