Long-term follow-up outcomes in low-risk and moderate-risk patients previously undergoing capsule sponge testing for Barrett’s surveillance

Objective While capsule sponge testing for Barrett’s surveillance has garnered increasing popularity, its ongoing use has been hindered by lack of long-term follow-up data. This study aims to analyse results of patients’ subsequent follow-up with either upper gastrointestinal (UGI) endoscopy or repeat capsule sponge testing in the lower risk patient cohort undergoing Barrett’s surveillance with capsule sponge testing within the CytoSCOT programme. Design/Method Patients with a previous capsule sponge test for Barrett’s surveillance demonstrating trefoil factor 3 (TFF3) positivity or negativity only between 14 September 2020 and 31 December 2021 were highlighted from the national CytoSCOT database. Electronic records were analysed to compare endoscopic biopsy results and outcomes in those undergoing follow-up with endoscopy versus repeat capsule sponge testing (±subsequent UGI endoscopy). All insufficient tests with missing biomarker data were excluded. Results 680 patients were included. 330/680 (48.5%) had endoscopic follow-up only. 350/680 (51.5%) had repeat capsule sponge testing; 67 of these patients (19.1%) subsequently proceeded to endoscopy. Of the 397 patients with confirmatory endoscopic biopsies, the incidence rates of low-grade dysplasia, high-grade dysplasia, intramucosal adenocarcinoma and oesophageal adenocarcinoma were 3.6%, 1.8%, 0.3% and 0.3% within the endoscopy only cohort and 4.5%, 4.5%, 1.5% and 0% within the repeat capsule sponge test cohort, respectively. There were no significant differences in the rates of detection of dysplasia or cancer between the two cohorts. Conclusion While long-term follow-up results are promising for patients previously undergoing Barrett’s surveillance with capsule sponge testing, further robust evidence is required to ensure dysplasia is not missed.