Non-endoscopic screening for Barrett's oesophagus and early adenocarcinoma
A swallowed sponge on a string can sample the oesophagus in a GP's office. Screen people with chronic reflux to catch adenocarcinoma at a curable stage.
Capsule sponge (Cytosponge-TFF3) detected ten times more Barrett's than usual care in the BEST3 trial (Lancet 2020); BEST4 (NIHR, 120,000 participants) tests whether screening and surveillance reduce mortality. Combining with methylation markers (EsoGuard) and AI histology could scale it.
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