NHS to bring ‘sponge-on-a-string’ cancer test to the high street

People with persistent heartburn or acid reflux will be offered an innovative ‘sponge on a string' test in high-street pharmacies for the first time, as part of a new NHS pilot to help prevent oesophageal cancer.

NHS England has today announced that dozens of pharmacies in England will offer new ‘heartburn health checks' to test for Barrett's oesophagus, which can be a precursor to oesophageal cancer.  

The test involves patients swallowing a small pill on a thread, which expands into a penny-sized sponge when it reaches the stomach. After a few minutes, it is safely pulled out to collect cells from the lining of the oesophagus, which are tested for pre-cancerous changes in the lab.

Delivered by a health professional in under 10 minutes, the test could help shift care from hospitals to the community as part of the 10-Year Health Plan, launched last week by the Government and NHS.

It is currently used in hospitals and Community Diagnostic Centres, helping reduce the need for invasive endoscopies and free up appointments for those at high risk of cancer – and the NHS will now pilot whether care could be made more convenient to help people get tested while they shop. 

Pharmacists will help spot patients who are regularly using over-the-counter medications to ease their heartburn or reflux symptoms but haven't come forward to their GP, aiming to spot early changes in the lining of the oesophagus that otherwise may have been missed.  

Partnering with Boots and gastrointestinal diagnostics company Cyted Health, from early next year around 1,500 people in London and the East Midlands will be offered the quick and easy test on-site in a pharmacy or be referred to a community-based clinic in their area.

Working closely with Heartburn Cancer UK, the pilot will be accompanied by a locally led public health awareness campaign on the potential signs and symptoms of oesophageal cancer to encourage more people to come forward.

The pilot will run for two years and the outcomes of an independent evaluation will inform decisions about any future roll-out.

Professor Peter Johnson, NHS national cancer director said: "The NHS is catching more cancers earlier than ever before, and this new pilot brings a convenient test to where people shop, making it easier than ever for patients to check signs and symptoms that might be worrying them.

"For the majority of people with persistent reflux, these quick and easy heartburn health checks will provide peace of mind that you aren't at increased risk of cancer, and for those who do find out they have Barret's oesophagus, regular follow-up checks will be put in place so any further cell changes can be spotted early.”

Gastro-oesophageal reflux, also known as acid reflux, is a relatively common condition, affecting around two in every ten people. Persistent symptoms can be a sign of the pre-cancerous Barrett's oesophagus, and this simple test can help spot whether heartburn is a sign of a more serious problem. 

If pre-cancerous cells are found, treatment can be offered to remove the cells through endoscopy or a procedure known as radiofrequency ablation.

Eddie, aged 77 from Suffolk credits the sponge on a string test with potentially saving his life after suffering from heartburn for most of his life: “It used to wake me up at night, but I always thought it was just one of those things. To think that something as simple as swallowing a capsule could uncover a hidden risk is truly remarkable. The test was quick, straightforward, and completely changed how I think about my health. 

“Knowing I have Barrett's oesophagus meant I was prioritised, my condition was monitored, and as a result my dysplasia was caught early. I am now able to get targeted treatment to stop my condition progressing to cancer, rather than finding out when it's too late. This never would have been caught if it wasn't for capsule sponge testing. This test gave me peace of mind and access to early treatment and could mean the difference between life and death for so many others.” 

Of almost 10,000 patients diagnosed with oesophageal cancer in the UK each year, 80% of patients are diagnosed at a late stage, where only 20% of patients survive the year – the key to saving lives is early diagnosis.

Cancer of the oesophagus is more common in older people, and men are more likely to have the cancer compared to women. Smoking, drinking alcohol and obesity are all factors that increase risk of the disease.

The technology has been deployed across the health service elsewhere to help reduce pressure on endoscopy services. The test has helped rule out the need for endoscopy – a more invasive procedure – for thousands of patients, freeing up appointments for those at higher risk of cancer. 

The project is one of 7 innovative pilots backed by a £15 million investment aimed to improve the early detection of cancer, as part of the NHS Cancer Programme's Innovation Open Call.

This third annual funding round by the NHS Cancer Programme, supported by SBRI Healthcare and the Accelerated Access Collaborative helps to fast-track leading innovations that could transform cancer diagnosis and treatment for patients to the front line of the NHS. 

This new funding brings the total investment across the three rounds of the NHS Innovation Open Call to almost £40 million, with over 200,000 patients already benefiting from the innovations.  

Marcel Gehrung, Co-founder and CEO of Cyted Health, said: “Too many people don't realise that persistent heartburn and chronic reflux can be warning signs of something more serious and that lack of awareness is costing lives. A capsule sponge test can detect conditions of the oesophagus early, before it's too late.

"We're proud to support this NHS pilot, bringing life-saving testing closer to the community, making it easier for more people to get checked, helping prevent avoidable deaths.”