Screening for oesophageal cancer

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.

What to do if you think you’re at risk

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

Talk to your GP if you think you are at a 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. Sometimes these cells can become cancerous over time. Only a small number of people with Barrett’s oesophagus go on to develop oesophageal cancer.

Monitoring Barrett's oesophagus

National guidelines generally recommend that people with Barrett’s oesophagus have regular gastroscopies to look for cell changes. They call this surveillance. Doctors will assess your general health to make sure the benefits of the surveillance tests outweigh the risks.

How often you have a gastroscopy if you have Barrett’s oesophagus depends on a number of factors. These include:

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

Capsule sponge test such as Cytosponge or Endosign

For this test you swallow a small capsule 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 nurse sends the sponge to the laboratory.

There are different capsule sponge products, these include Cytosponge and Endosign.

In Scotland, the capsule sponge test is used to diagnose and monitor some people with Barrett’s oesophagus. There are trials and projects taking place in different parts of England and Wales. They are looking at the use of this test in people with symptoms and those with a diagnosis of Barrett’s oesophagus. If these are successful, the capsule sponge test might be used more widely in the NHS for people with Barrett’s oesophagus.

Treatment for Barrett's oesophagus

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

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

You might also have a medicine to lower the amount of acid that your stomach produces.