Barrett's Oesophagus: A Case Study

Introduction Imagine swallowing a pill and having it yanked out of your esophagus moments later to find whether or not you may have cancer. Welcome to the new age, in which there exists the cytosponge. The cytosponge is a swallowable device, which collects cells which may contain biomarkers for Barrett's oesophagus, the precursor to esophageal cancer (Lao-Sirieix, P., & Fitzgerald, R. C. , 2010). Around 1% of human cancers start in the esophagus — and only 19% of patients with esophageal cancer survive for five years after diagnosis , making it a serious condition. Adenocarcinoma originates in glandular cells — cells that produce fluids, such as mucus (National Cancer Institute, 2017).

The cytosponge has the potential to replace endoscopies

In addition, the medical community accepts the cytosponge as a tool only for use in routine screening for Barrett’s Esophagus in at-risk patients such as those with gastro-oesophageal reflux disease (GERD), which is proven through the intended purpose of the cytosponge stated in its patent (Lao-Sirieix, P., & Fitzgerald, R. C. , 2010). There is no evidence that the cytosponge will ever completely replace endoscopies, and endoscopies will continue to be used for patients with more serious cases than just being at risk for EAC, or for patients requiring endoscopies for other conditions. Also, despite the more common use of endoscopies, the cytosponge is also a valid method of testing with a high level of accuracy; it has a specificity of 94% and a sensitivity of 78%-90% while accepted tests such as those for prostate, cervical and colon cancer have sensitivities of 30-96% and sensitivities of 77-100% (Kadri, Lao-Sirieix, Fitzgerald, 2011). So comparably, using a cytosponge is a very reliable method for testing the presence of Barrett’s

The majority of Buddhists, Sikhs and Jainists are all Asian who, as a demographic, have a rate of incidence of just 4.3 cases per 100,000 people (National Cancer Institute, 2017). By comparison, caucasians have a rate of incidence of 9.0 cases per 100,000 people, more than twice the incidence of asians, and blacks have a rate of incidence of 9.2 cases per 100,000 people (National Cancer Institute, 2017). So, although the cytosponge would be less accessible to certain ethnic groups in Asia, it is extremely less necessary in that location due to the lack of people at risk. In addition, if the cytosponge were to become the standard method to test for Barrett’s Esophagus, it wouldn’t necessarily be implemented in locations with a high concentration of vegetarians, and there could be exceptions, in which people can opt in for an endoscopy. With this issue in mind, there is also a possibility of developing another cytosponge using vegetarian ingredients such as carrageenan (a commonly utilized vegetarian gelatin-substitute) in order to increase the amount of patients with the option to use the cytosponge for screening and to therefore increase its use and availability to a wider range of