Acceptability of the Cytosponge procedure for detecting Barrett's oesophagus: a qualitative study

Abstract

ObjectiveTo investigate the acceptability of the Cytosponge, a novel sampling device to detect Barrett's oesophagus (BE), a precursor to oesophageal adenocarcinoma (EAC), among people with risk factors for this condition.DesignA qualitative study using semistructured interviews and focus group discussions. Data were explored by three researchers using thematic analysis.SettingCommunity setting in London, UK.ParticipantsA recruitment company identified 33 adults (17 men, 16 women) aged 50–69 years with gastro-oesophageal reflux disease (GERD), a risk factor for BE. The majority of participants were white British (73%). The focus groups were stratified by gender and education. 10 individuals were interviewed and 23 participated in four focus groups.Results3 key themes emerged from the data: the anticipated physical experience, preferences for the content of information materials and comparisons with the current gold-standard test. Overall acceptability was high, but there was initial concern about the physical experience of taking the test, including swallowing and extracting the Cytosponge. These worries were reduced after handling the device and a video demonstration of the procedure. Knowledge of the relationship between GERD, BE and EAC was poor, and some suggested they would prefer not to know about the link when being offered the Cytosponge. Participants perceived the Cytosponge to be more comfortable, practical and economical than endoscopy.ConclusionsThese qualitative data suggest the Cytosponge was acceptable to the majority of participants with risk factors for BE, and could be used as a first-line test to investigate GERD symptoms. Concerns about the physical experience of the test were alleviated through multimedia resources. The development of patient information materials is an important next step to ensuring patients are adequately informed and reassured about the procedure. Patient stakeholders should be involved in this process to ensure their concerns and preferences are considered.Trial registration numberISRCTN68382401; pre-results.

Safety and Acceptability of Esophageal Cytosponge Cell Collection Device in a Pooled Analysis of Data From Individual Patients

“…Our review showed that of 2,672 Cytosponge ® procedures there were only two SAE that could be directly attributed to the device (<1: 2,000) and both resolved without any ill-effects for the patient. The detachment is the most concerning risk factor to both clinicians and patients 28 . However, a retained sponge in the stomach would not be expected to cause any symptoms as was the case in the patient reported here.…”

“…Previous interview-based, quality study on 33 participants with GERD showed that Cytosponge ® is acceptable for most participants, as well as being preferred to endoscopy 28 . In our study, most patients (79.3%) scored their experience as at least “neutral” (VAS≥5) and the median VAS score was 6.0 (IQR 5.0–8.0).…”

Barrett-Screening: rationale, aktuelle Konzepte und Perspektiven

“…Die Verwendung der Abrasiv-Zytologie als Screening-Verfahren auf BE und EAC ist dagegen eine relativ neue Methode (▶ Abb. 3) [54].…”

“…Die Ergebnisse dieser Studie werden erstmals Evidenz zu der Frage erbringen, ob mit diesem einfachen, billigen sowie anwender-und patientenfreundlichen Verfahren ein effektives Screening auf Barrett-Ösophagus betrieben werden kann und die sich ggf. anschließende Surveillance tatsächlich in der Lage ist, das Outcome (tumorassoziierte und Gesamtmortalität) signifikant zu verbessern [54]. Speziell zur risikoadaptierten Surveillance beim Barrett-Ösophagus wird zusätzlich eine weitere britische prospektive, randomisierte und populationsbasierte Studie Antworten liefern (BOSS-Trial) [60].…”

Barrett-Screening: Rationale, aktuelle Konzepte und Perspektiven

“…Die Ergebnisse dieser Studie werden erstmals Evidenz zu der Frage erbringen, ob mit diesem einfachen, billigen sowie anwender-und patientenfreundlichen Verfahren ein effektives Screening auf Barrett-Ösophagus betrieben werden kann und die sich ggf. anschließende Surveillance tatsächlich in der Lage ist, das Outcome (tumorassoziierte und Gesamt-Mortalität) signifikant zu verbessern [54]. Speziell zur risiko-adaptierten Surveillance beim Barrett-Ösophagus wird zusätzlich eine weitere britische prospektive, randomisierte und populationsbasierte Studie Antworten liefern (BOSS-Trial) [60].…”