‘Pill-on-a-thread’ cancer screening trial rolled out to Welsh communities

Mark Mansfield

People who suffer from long-term heartburn, indigestion or acid reflux are being invited to take part in a cancer screening trial using a pioneering “pill-on-a-thread” test.

The BEST4 Screening Trial is using mobile clinics in Wales to investigate whether a capsule sponge can help identify people at increased risk of oesophageal cancer without the need for an endoscopy.

The trial is open to men aged 55 to 79 and women aged 65 to 79, with mobile screening units visiting Cardiff and Abergavenny during August.

Researchers are investigating whether the test could be used to screen people with chronic heartburn for Barrett’s oesophagus, a condition linked to long-term acid reflux which can increase the risk of oesophageal cancer.

Participants swallow a small capsule attached to a thread. Once it reaches the stomach, the capsule dissolves and releases a sponge, which is then gently pulled back up to collect cells from the lining of the oesophagus.

The cells are subsequently analysed for signs of Barrett’s oesophagus.

The wider appointment takes around 35 minutes, while the capsule sponge procedure itself takes around 10 minutes and is carried out by a nurse.

Researchers hope it could provide a quicker and less invasive way of identifying people who require further investigation.

Mobile clinics

The BEST4 mobile screening unit is at Tesco Extra on Excelsior Road in Cardiff until August 7 and will return there from August 10 to 19. It will then move to Waitrose at Llanfoist, near Abergavenny, from August 20 to 28.

Eligible people may receive a text message from NHS Wales inviting them to register with the Heartburn Health programme. Some of those who meet the trial criteria will then be randomly selected for an appointment.

People who have not received a text but are interested can also register with Heartburn Health to be considered.

One participant is 68-year-old Cardiff resident Phil Walters, who has suffered from heartburn for more than 25 years.

He said: “When I heard about the trial, I wanted to get involved and support research that could help improve care for other people in the future.

“I think bringing research directly into communities is a great idea.

“The BEST4 mobile unit makes it much easier for people to take part in research closer to home, and I’d encourage anyone who’s invited to consider getting involved.”

Earlier detection

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, the BEST4 trial aims to recruit 120,000 people over three years who regularly take medication for heartburn.

The £6.4m UK-wide study is funded by Cancer Research UK and the National Institute for Health and Care Research, with its delivery in Wales supported by Welsh Government funding through Health and Care Research Wales.

Professor Rebecca Fitzgerald, who invented the capsule sponge test and is co-principal investigator of the BEST4 trials, said: “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.”

Irene Debiram-Beecham, principal research nurse and BEST4 clinical coordinator, said the mobile units were intended to make participation easier.

She said: “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.”

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