Scientists have finally invented a minimally invasive way to detect if people are at risk for esophageal cancer. The new approach – a small, swallowable balloon for collecting samples coupled with DNA analysis – could be a promising alternative to endoscopy (a time-consuming procedure that requires sedation) in diagnosing Barret’s esophagus (BE), which is a precursor for esophageal carcinoma.
Approximately 95% of BE cases go undetected until a patient progresses to esophageal adenocarcinoma, which has a poor prognosis and a five-year survival rate of less than 20%. The incidence of esophageal adenocarcinoma has more than quadrupled over the past three decades, spurring Helen Moinova and colleagues to devise a device and biomarker-based detection method that could help make BE screening part of routine clinical procedure.
After analyzing samples from hundreds of individuals, Moinova et al. zeroed in on a DNA modification pattern within cells of the lower esophagus that identified BE with more than 90% sensitivity and specificity.
Interestingly, the researchers noted that smoking altered DNA modification in the upper esophagus, but deeper regions were unaffected.
To create a device that could collect cells from the lower esophagus, the scientists invented a small capsule only slightly longer than an aspirin containing a balloon and connected to a catheter for inflation once it reached the stomach (roughly three minutes after being swallowed). After inflation, the balloon gently brushed the esophagus to collect cell samples for DNA analysis.
Among 128 individuals who swallowed the device, none reported anxiety, pain, or choking and a majority said they would recommend the procedure to a friend.