Brief Comments on the Rapid Response (RR) Report from Healthcare Improvement Scotland on the Use of Cytosponge™ for the Detection of Pre-malignant or Early Curable Oesophageal Cancer

van der Meer, Robert (2021) Brief Comments on the Rapid Response (RR) Report from Healthcare Improvement Scotland on the Use of Cytosponge™ for the Detection of Pre-malignant or Early Curable Oesophageal Cancer. [Report]

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Abstract

It can be argued that the question of capacity – in particular, the current (and quite possibly prolonged) lack of hospital resources to conduct planned endoscopy procedures in a timely manner – has received insufficient attention in the recent Rapid Response report from HIS. Widespread use of Cytosponge would enable substantially more patients (50% or more depending on COVID-19 and other factors) to be seen in any given period. Although endoscopy plus biopsy appear to have superior sensitivity (although still less than 100%) and specificity than Cytosponge, this advantage can be negated by a lack of effective capacity to perform these resource-intensive procedures in a timely manner. Instead, using Cytosponge for suitable patients would allow them to be seen and diagnosed closer to the originally planned time, leading where necessary to faster treatments with associated gains in quality-adjusted life years. Any (potentially false) negative results from the Cytosponge test could be reconsidered within a reasonable period of time should the patient’s symptoms persist or worsen.

ORCID iDs

van der Meer, Robert ORCID logoORCID: https://orcid.org/0000-0002-9442-1628;