A271: New screening method for patients at high risk of esophageal adenocarcinoma using encapsulated sponge
1Ontario Institute for Cancer Research, Toronto, Canada,2Division of Gastroenterology, St Michael’s Hospital, Toronto, Canada,3University of Rochester Medical Center, School of Medicine and Dentistry, Rochester, NY, USA,4Boston University, School of Medicine, Boston, MA, USA
It is known that many cancer cases are preventable either by changing life style or participating in screening/surveillance programs. It is easier, cheaper and more efficient to prevent or detect and treat early than try to cure a disease at the advanced stages.
The single major risk factor for development of esophageal adenocarcinoma (EAC), a devastating disease with 15% survival rate, is gastroenterological reflux disease, which commonly leads to a change in the lining of the esophagus called Barretts Esophagus (BE). Patients with BE are recommended to undergo periodic surveillance endoscopies with biopsies to detect progression to dyspasia and EAC. In practice, endoscopic surveillance of patients with BE is expensive, uncomfortable and not cost-effective. It involves sedation, loss of a workday and has occasional complications. For these reasons, many primary care physicians and their patients are reluctant to commit to endoscopy. Consequently, only 5% of BE patients are covered by a surveillance program.
We are proposing a new diagnostic test for screening BE patients that is based on the usage of the EsophaCap: swallowable encapsulated sponge. The patient swallows the sponge in its encapsulated state leaving the end of the tether coming out of his mouth. The capsule dissolves in the warmth and moisture of the stomach over a period of several minutes. The sponge is than retrieved by gently pulling on the tether. By adding genomic technologies to this test, we hope to follow Barretts patients at periodic intervals in order to identify and treat those who are progressing to cancer. The test could be easily done in primary doctors offices. With this quick and painless technique we are hoping to significantly increase the number of BE patients covered by surveillance program and reduce mortality rate from EAC.