Screening

There is no national screening programme for oesophageal cancer in the UK. But people who are at higher risk of developing oesophageal cancer have regular checks. This includes people with Barrett’s oesophagus.

What is cancer screening?

Screening means testing people for early stages of a disease. This is before they have any symptoms. For screening to be useful the tests:

• need to be reliable at picking up cancers
• overall must do more good than harm to people taking part
• must be something that people are willing to do

Screening tests are not perfect and have some risks. The screening programme should also be good value for money for the NHS.

Screening for oesophageal cancer

There is no national screening programme for oesophageal cancer in the UK. This is because:

• there isn’t a sensitive enough test available
• those tests that are available find low numbers of cancers
• they have risks
• they can be expensive

The only way doctors can screen for oesophageal cancer is with an endoscopy, at the moment. This test means they can look at the lining of the food pipe and take tissue samples (biopsies). There are risks with this procedure, such as bleeding or a small tear in the lining of the food pipe but they are rare.

People who are at higher risk of developing oesophageal cancer have regular checks. This includes people with Barrett’s oesophagus.

What to do if you think you’re at risk

Talk to your GP if you think you are at higher than average risk of oesophageal cancer.

Barrett’s oesophagus

Barrett’s oesophagus means that there are abnormal cells in the lining of the food pipe. These cell changes can change into cancer over time. Only a small number of people with Barrett’s go on to develop oesophageal cancer.

Monitoring Barrett's oesophagus

The British Society of Gastroenterology (BSG) generally recommend that people with Barrett’s oesophagus have regular endoscopies to look for cell changes. They call this surveillance.

When deciding about whether to do regular endoscopy doctors assess the general health of the patient and ensure that the benefits of screening outweigh the possible risks.

How often you have an endoscopy if you have Barrett’s oesophagus depends on a number of factors. This includes:

• how abnormal the cells are
• how much of the oesophagus the Barrett’s is affecting

Treatment

People who have very abnormal changes in the cells will have treatment.

People who have some low grade changes have a repeat endoscopy 6 months later. Your doctor might then treat the abnormal cells. You will continue to have 6 monthly endoscopy if you don't have treatment.

Research into screening tests

Researchers are trying to find out if something called a cytosponge can pick up Barrett’s oesophagus. This test is only available as part of a clinical trial.

What is a cytosponge?

A cytosponge is a small capsule which you swallow, along with a drink of water. The capsule contains a sponge that is attached to a string.

The sponge is covered in gelatine which takes about 5 minutes to dissolve in your stomach. The nurse then gently removes the sponge by pulling the string. As they pull the sponge up and out of your mouth, it collects cells from the lining of your oesophagus. The research nurse sends the sponge to the laboratory.

The researchers compare the findings of the cytosponge test with the results of the endoscopy to see how accurate the cytosponge is.