Can a Swallowable Capsule Revolutionize Screening for Barrett’s Esophagus?

Although the rate of many common cancers has declined, the incidence of esophageal adenocarcinoma has increased greater than six-fold over the past three decades. Furthermore, the outcome of this cancer remains poor, accounting for over 1 in 50 adult male cancer-related deaths.

Barrett’s esophagus (BE), a precursor of esophageal cancer, can be easily recognized at endoscopy; however, current clinical strategies of endoscopic screening and surveillance based on the close association of BE with chronic gastroesophageal reflux disease (GERD) in adults are woefully inadequate. Despite endoscopic screening and surveillance efforts, less than 5 percent of esophageal cancers are diagnosed in individuals with previously detected BE.

The National Institutes of Health is funding a multicenter clinical trial aimed at improving outcomes for patients with BE and esophageal cancer. Prashanthi Thota, MD, Director for Center of Swallowing & Motility Disorders at Cleveland Clinic, and study collaborators at different academic centers are testing whether a swallowable capsule can gather a sample and assay methylated DNA biomarkers to diagnose BE and esophageal cancer.

Inclusion criteria

Adult white males with GERD for five years or longer are the group at the highest risk for BE and esophageal cancer, which is reflected in the study’s inclusion criteria. The study is trying to recruit subjects who have not had prior EGD and are:

• Male gender
• White race
• Age > 40 < 85
• GERD > 5 years
• No prior EGD

OR have GERD > 5 years, Age > 40 < 85, and No prior EGD PLUS at least three of the following criteria:

• Male gender
• White race
• Obesity (BMI > 30)
• History of smoking
• Family history – two family members with reported BE or esophageal cancer

If you have a patient who could benefit from this clinical trial, please email Dr. Thota at thotap@ccf.org or call at 216.444.0780.