Pill-on-a-thread’ cancer screening trial launches in Wales

Mark Mansfield

A pioneering “pill-on-a-thread” test that could transform the early detection of oesophageal cancer is being rolled out across Wales as part of a major UK clinical trial.

The BEST4 Screening Trial will investigate whether the capsule sponge test can be used to screen people with chronic heartburn for Barrett’s oesophagus – a condition that can develop into oesophageal cancer.

Unlike an endoscopy, the test takes around 10 minutes and can be carried out by a trained nurse. Researchers hope it will identify people who need further investigation earlier, leading to faster treatment while reducing pressure on NHS endoscopy services.

Backed by £6.4 million from Cancer Research UK and the National Institute for Health and Care Research (NIHR), the study is being delivered in Wales with Welsh Government funding through Health and Care Research Wales using mobile screening vans to bring the research into communities.

Around 1,322 people in Wales were diagnosed with oesophago-gastric cancer, which includes oesophageal cancer, between April 2021 and March 2023. Across the UK, oesophageal cancer is the seventh leading cause of cancer deaths, claiming around 22 lives each day.

Over the next three years, the trial aims to recruit 120,000 people across the UK who regularly take medication for heartburn, the most common symptom of Barrett’s oesophagus.

Participants in Wales will be invited by text message from NHS Wales to join the study. The trial is open to men aged 55 to 79 and women aged 65 to 79 who currently take medication for chronic heartburn.

Irene Debiram-Beecham, principal research nurse and BEST4 clinical coordinator, said:

“We’re delighted to be bringing the BEST4 Screening Trial to communities across Wales. The capsule sponge test is quick and straightforward, taking around ten minutes and carried out by a trained nurse.

“By using mobile screening units, we’re making it easier for people to take part closer to home. Every person who joins the study will help us understand whether this approach could play a role in identifying people at risk of oesophageal cancer earlier in the future.

“If you receive an invitation, we encourage you to consider taking part and helping us build the evidence needed to improve care for future generations.”

Professor Rebecca Fitzgerald, who invented the capsule sponge test and is co-principal investigator of the BEST4 trials, said years of research had shown the test could reliably identify Barrett’s oesophagus.

She said: “The BEST4 Screening trial is the pinnacle of many years of painstaking research, which has demonstrated that the capsule sponge can reliably identify Barrett’s oesophagus.

“Thousands of people have already benefited in trials and pilot programmes, and now we’re taking the test to the next level to see if we could offer this to everyone with heartburn.

“The BEST4 Screening trial could fundamentally transform the lives of people affected by oesophageal cancer by providing the crucial evidence needed to make it a viable screening programme, rolled out to every part of the UK.”

Innovative research

Dr Nicola Williams, national director of support and delivery at Health and Care Research Wales, said the project demonstrated how research could be taken directly into communities.

She said: “BEST4 is an exciting example of how innovative research can be brought directly into communities, making it easier for people to take part in studies that have the potential to improve lives.

“By using mobile screening vans and new approaches to identifying people at risk, this trial will help reach people closer to home while generating evidence that could reduce pressure on NHS services in the future.”

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