Early detection of oesophageal cancer
Early detection of oesophageal cancer
Despite the celebrated improvements in survival rates for many types of cancer, survival rates for cancer of the oesophagus, or food pipe, remain comparatively low. One contributing factor is the lack of a screening test for squamous cell carcinoma (SCC), one of the two types of oesophageal cancer.A grant from the Evelyn Trust has supported the research of Professor Rebecca Fitzgerald, from the University of Cambridge, as she works to develop effective screening that will benefit patients worldwide.
While more than 480,000 patients are diagnosed each year with oesophageal cancer, 430,000 patients die each year – a survival rate of only about 20% in the western countries and a shocking10% in the developing world. Screening and early diagnosis have the potential to revolutionise survival rates and gastroscopy, an uncomfortable and experience, has been the standard method for examining the food pipe and taking tissue samples. More recently Professor Fitzgerald has been involved with the development of an alternative - the CytospongeTM. This is a small sponge that’s easily swallowed in a capsule, expands in the stomach and is then is drawn gently back up the throat using the string attached. It collects cells for analysis from the lining of the oesophagus as travels back up to the mouth, so helping patients to avoid invasive procedures.
The project funded by the Evelyn Trust focussed on squamous cell carcinoma and aimed to find two ‘biomarkers’ that typically indicatethe presence of this cancer in the food pipe and could be testedin samples collected using the sponge method, so avoiding gastroscopy.
Professor Fitzgerald and her team were successful in analysing vast quantities of genetic data, starting with 50 ‘key suspect’ genes and systematically narrowing the group down to eventually identify and validate two genes that showed themselves as ‘biomarkers’ - present in abnormal quantities when a patient is suffering from SCC, or precursors of SCC.The project also included analysis of the presence of the tumour suppressor gene (p53) – a genethat had already been linked to the development and progression of SCC.
Now that the two ‘biomarkers’ have been identified and, as a successful screening test is already available for the early stages the second type of oesophageal cancer – adenocarcinoma – Professor Fitzgerald is optimistic that we now on the way to a simple, cost-effective, non-invasive screening test for both types of oesophageal cancer using the Cytosponge™.
The enormous potential of Professor Fitzgerald’s work has gained international attention – particularly in China. Professor Fitzgerald explains why: “Oesophageal cancer is sadly very prevalent in China:half of all squamous cell carcinomas worldwide are diagnosed in China alone. The Chinese government is investing heavily in endoscopic screening for oesophageal cancer but unfortunately this has failed to reduce mortality rates.We are very excited that a large scale screening study is now planned using the CytospongeTM method. The Chinese authorities are attracted to the method as costs are low and healthcare workers needrelatively little expertise for diagnosis of early cancer. If this study is successful, the Chinese government may decide to implement the Cytosponge™ test.”
Screening and early diagnosis have been shown to be vital in reducing the number of deaths from all types of cancer. The work of Professor Fitzgerald, part-funded by the Evelyn Trust, is playing a vital role in the development of screening for a disease that affects all populations, but is today a serious and disproportionate burden in the developing world.