New technology to help NHS Boards meet demand - The Cytosponge

5th October 2020

Innovative new health technology is being adapted by Scotland's NHS to improve patient care and meet demand for services that had to be paused due to COVID-19.

The Cytosponge is one example of this, offering a faster, simpler alternative to endoscopy procedures for diagnosing conditions such as Barrett's Oesophagus, which is a known risk factor for oesophageal cancer.

The procedure involves patients swallowing a small pill with a thread attached. This expands into a tiny sponge and is pulled back up, collecting cells on the way, and molecular analysis is then used to identify any abnormal cells.

NHS Greater Glasgow and Clyde and NHS Lanarkshire are the first Boards to implement the new technology, which will be introduced to all Boards through a phased implementation, with training planned for NHS Fife, Borders, Forth Valley, and Lothian later this month.

The Scottish Government has initially allocated £500,000 to enable the implementation of Cytosponge, to support the resumption of key health services that were paused because of COVID-19, as part of NHS Scotland’s recovery plan for gastrointestinal services.

Health Secretary Jeane Freeman said:"Cytosponge is part of an accelerated roll-out of innovative technologies being embraced by Scotland’s NHS to support the resumption and recovery of vital health services that had to be paused because of the pandemic.

"It is a much simpler and more patient friendly test than endoscopy that enables faster diagnosis of patients at risk of pre or early cancer, without the need for them to undergo a more invasive procedure.

“The Scottish Government is working at pace with Health Boards, National Services Scotland (NSS), and industry partners to safely resume NHS services and this new tool further strengthens our ability to provide vital health services, and protect patients across Scotland."

Unlike endoscopy procedures, where clinicians use a long, thin, flexible tube with a light and camera at one end to inspect organs inside the body, Cytosponge is a non-Aerosol Generating Procedure (AGP) and can be performed outside of traditional hospital environments, such as community health centres or general outpatient clinics .

The idea for the Cytosponge began over 10 years ago when Professor Rebecca Fitzgerald and her team at the University of Cambridge set about finding an effective way to diagnose and monitor people with Barrett’s oesophagus. Once they'd developed the ingenious ‘sponge on a string’ pill method of collecting the cells, the team then needed to create a reliable test to analyse them and to distinguish cells at risk of becoming cancerous from normal cells. Their research identified a protein, called TFF3 (Trefoil Factor 3), which is found only in the pre-cancerous cells. They created an antibody test that can flag up cells containing this marker protein.

An aerosol generating procedure (AGP) is a medical procedure that can result in the release of airborne particles (aerosols) from the respiratory tract. AGPs are associated with increased risk of transmitting COVID and require additional personal protective equipment (PPE) to be performed safely.