Date: 20 August 2019
CRN Wessex research nurses in collaboration with GP practices have recruited 1,500 participants to a study investigating the effectiveness and acceptability of a new device in the early detection of abnormal cells in the oesophagus of patients with acid reflux symptoms.
Since 2017, the BEST3 study has invited patients aged 50 and over who have been taking prescribed medication for acid reflux or heartburn for more than six months, to their local GP surgery to participate in the research study. The study, which trials a device called a Cytosponge, has been delivered at 12 GP surgeries across Wessex.
The Cytosponge device is enclosed in a capsule which is attached to a string. The patient is asked to swallow the capsule, wait up to five minutes to ensure the capsule is dissolved, thus releasing the Cytosponge into the patient’s stomach. The nurse then pulls the Cytosponge out via the attached string, allowing it to collect cells as it passes through the patient’s oesophagus. Researchers can then check these cells for signs of Barrett’s oesophagus. Across Wessex, the device was trialled on 180 participants.
Approximately 3-6 % of people with regular heartburn, acid reflux or indigestion will develop Barrett’s oesophagus, a condition which is caused by acid reflux and which can lead to the development of abnormal cells. Because of this, people with Barrett’s oesophagus have a somewhat higher chance of developing oesophageal cancer. The main aim of the BEST3 trial is to find out whether, by offering the Cytosponge test, more patients can receive an early diagnosis of Barrett’s oesophagus.
Nationally, since study set up in 2017, 13,000 participants have been recruited into BEST3, of which 1,800 have been tested with the Cytosponge device.
Ruth Gibbins, a research nurse from CRN Wessex, says, “I led the delivery of the BEST3 trial in Wessex. A lot of planning had to take place to ensure we had enough nurses trained to undertake not only the recruitment of participants, but also delivering the Cytosponge test which is quite a novel skill. The BEST3 Clinical Coordinator came down to Wessex to observe the nurses delivering at least five Cytosponge tests in order to confirm their competence. The nurses had the opportunity to consolidate this novel skill through planned clinics."
The standard of care to diagnose Barrett’s oesophagus involves an endoscopy, which is an invasive procedure that can have some adverse effects and can be uncomfortable.The Cytosponge test provides a more comfortable alternative to the endoscopy with no serious side effects.
Ruth comments, “The Cytosponge test was generally well-tolerated by participants and it was exciting to be able to offer a novel device that is less invasive than an endoscopy to detect Barrett's cells in the oesophagus.”
To find out more about the BEST3 trial, you can visit their website.
This study is funded by Cancer Research UK and jointly sponsored by Cambridge University Hospitals NHS Foundation Trust and University of Cambridge.