A trial of a GP-based test for patients with heartburn, reflux and/or indigestion symptoms, BEST3 assessed whether the CytospongeTM test – a capsule on a string, which expands into a small sponge in the stomach – was effective in increasing the detection of Barrett’s oesophagus in primary care and could help detect early cancerous changes.
Open to join between 2017 and 2019, the BEST3 research team identified more than 13,000 people from 109 different GP surgeries across England, to take part. The trial team found that the Cytosponge helped diagnose ten times as many cases of Barrett’s oesophagus compared to standard care. In some cases, a positive Cytosponge test also led to a diagnosis of earlier stage oesophageal cancer. The cancers diagnosed from the usual care arm were more advanced.
The POSTCARD Study
POSTCARD – the Pathway to Oesophageal and STomach CAnceR Diagnosis Study – had the overall aim of improving the diagnosis of oesophageal and gastric (stomach) cancer by exploring symptom experience and appraisal, self-treatment behaviours, help-seeking decisions, and the influence of health literacy on the total diagnostic interval in patients with these cancers.
The study took place in two hospitals across two regions (the East and North East of England) to provide geographical and socio-cultural diversity. Adult patients recently diagnosed with oesophageal or gastric cancer were invited to participate by a specialist nurse/researcher and invited to complete a questionnaire about their symptoms, other illnesses they may have, their confidence with health information and in talking to doctors and nurses (health literacy). It was followed up with face-to-face interviews with participants within 10 weeks of their diagnosis.
The results should help contribute to our understanding of patient pathways leading to the diagnosis of oesophageal and gastric cancer and contribute to new strategies for promoting earlier presentation, referral and diagnosis of these cancers, as well as safety-netting patients with upper gastrointestinal symptoms who consult in primary care.
For more information please contact: Fiona Walter
ECASS – Evaluating a Computer Aid for Assessing Stomach Symptoms – is a multi-site phase II exploratory cluster randomised controlled trial that aims to generate new knowledge on the process measures regarding the use of electronic clinical decision-support tools in primary care. For most cancers, only a minority of patients have symptoms meeting the NICE guidance for urgent referral. For gastro-oesophageal cancers, the ‘alarm’ symptoms of dysphagia and weight loss are reported by only 32 and 8% of patients, respectively, and their presence correlates with advanced-stage disease.The trial aims to explore the effectiveness of electronic clinical decision-support tools that have been developed for general practice in relation to stomach symptoms. Read the full protocol.
SuSPECT – StrategieS to oPtimise Early deteCtion on pancreaTic cancer – aims to determine how existing diagnostic tests can be used more effectively in primary care to manage lower risk upper gastrointenstinal symptoms. By identifying strategies for improving GP testing and referral decisions for these symptoms, a more timely diagnosis of pancreatic cancer should be possible.
For more information please contact: Victoria Hardy
Communication of Upper Abdominal Symptoms
An exploratory qualitative study of patients communication of upper abdominal symptoms and GPs interpretation of those symptoms, using archived qualitative data.