BJS 3 On the use of Cytosponge as a tool to manage the burden of Barrett’s surveillance

Introduction

After the Covid pandemic, a backlog of over a million endoscopies built up in the UK. Many patients with Barrett’s oesophagus did not receive surveillance within recommended time frames as Barrett’s surveillance endoscopies take more time. This study aimed to assess the role of the Cytosponge test in Barrett’s surveillance and whether it could help reduce endoscopy backlogs.

Methods

251 patients waiting for Barrett’s surveillance prior to or in 2022 were triaged. Patients suitable for Cytosponge were approached and offered this procedure in lieu of endoscopy. Outcomes, complications and reduction in endoscopy usage were measured.

Results

193 patients (77%) had a Cytosponge procedure as their primary Barrett’s surveillance. Of the remaining 58 patients, 26 were unsuitable and 29 patients could not be contacted to discuss the test. 3 patients declined a Cytosponge. 121 patients (62%) had waited longer than their recommended interval for Barrett’s surveillance.

There were no significant complications. Urgent endoscopy was required in 18 patients (9%) after Cytosponge; 15 patients had abnormal findings and 3 patients had an inadequate sample. 175 patients (91%) did not require endoscopic assessment after Cytosponge and have been booked for routine surveillance.

Conclusions

Over 90% of patients who had a Cytosponge for Barrett’s surveillance did not require endoscopy. This ‘saved’ almost 440 points of endoscopy time (or 44 endoscopy lists). Given that around 1% of adults develop Barrett’s oesophagus, these data suggest substantial opportunities to reduce burden of surveillance endoscopies if Cytosponge was used as a primary test for Barrett’s oesophagus.