Oesophageal cell collection device and biomarker testing to identify high-risk Barrett’s patients requiring endoscopic investigation

Sep 21, 2026

Uploaded by Eliana

Barrett’s oesophagus surveillance relies on endoscopic detection of early neoplastic change, yet it burdens endoscopy services. An oesophageal cell collection device (OCCD) testing programme was introduced across Scotland during the COVID-19 pandemic. This national pragmatic retrospective study evaluates whether CytoSCOT OCCD testing successfully identifies high-risk Barrett’s patients who require urgent endoscopic investigation. Patients undergoing OCCD testing across 11 health boards were followed for endoscopy within 12 months, using atypia and p53 positivity as high-risk criteria.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages6

Reading Time15 min

AccessFree to download

Abstract

Background

Methods

Results

Conclusion

Introduction

BJS, 2024, znae117 [https://doi.org/10.1093/bjs/znae117](https://doi.org/10.1093/bjs/znae117) Original Article Oesophageal cell collection device and biomarker testing to identify high-risk Barrett’s patients requiring endoscopic investigation Siobhan Chien1,2,* , Paul Glen3, Ian Penman4, Neil Cruickshank5, Gavin Bryce6, Andrew Crumley7, Perminder Phull8, Michael Miller9, Jonathan Fletcher10, Ivan Gunjaca11, Jeyakumar Apollos12, Kevin Robertson13 and Grant Fullarton2 1School of Cancer Sciences, University of Glasgow, Glasgow, UK 2Centre for Sustainable Delivery, Golden Jubilee National Hospital, Glasgow, UK 3Department of General Surgery, Queen Elizabeth University Hospital, Glasgow, UK 4Centre for Liver & Digestive Disorders, Royal Infirmary of Edinburgh, Edinburgh, UK 5Department of General Surgery, Victoria Hospital, Kirkcaldy, UK 6Department of General Surgery, University Hospital Wishaw, Wishaw, UK 7Department of General Surgery, Forth Valley Royal Hospital, Larbert, UK 8Department of Gastroenterology, Aberdeen Royal Infirmary, Aberdeen, UK 9Department of Gastroenterology, Ninewells Hospital, Dundee, UK 10Department of Gastroenterology, Borders General Hospital, Melrose, UK 11Department of Gastroenterology, Raigmore Hospital, Inverness, UK 12Department of General Surgery, Dumfries & Galloway Royal Infirmary, Dumfries, UK 13Department of General Surgery, University Hospital Crosshouse, Kilmarnock, UK *Correspondence to: Siobhan Chien, Centre for Sustainable Delivery, Golden Jubilee National Hospital, Clydebank, Glasgow G81 4DN, UK (e-mail: siobhan. chien6@ [gjnh.scot.nhs.uk](gjnh.scot.nhs.uk)) Abstract Background: Barrett’s oesophagus surveillance places significant burden on endoscopy services yet is vital to detect early cancerous change. Oesophageal cell collection device (OCCD) testing was introduced across Scotland for Barrett’s surveillance in response to the COVID-19 pandemic. This national pragmatic retrospective study presents the CytoSCOT programme results and evaluates whether OCCD testing is successfully identifying high-risk Barrett’s patients requiring urgent endoscopy. Methods: All patients undergoing OCCD testing for Barrett’s surveillance across 11 Scottish health boards over a 32-month period were identified. Patients who underwent endoscopy within 12 months of OCCD test were included. Individual patient records were interrogated to record clinical information and OCCD test result to categorize patients into risk groups. Endoscopic histopathology results were analysed according to risk group and segment length. Patients were deemed high risk if the OCCD test demonstrated atypia and/or p53 positivity. Results: 4204 OCCD tests were performed in 3745 patients: 608 patients underwent endoscopy within 12 months and were included in this analysis. Patients with longer Barrett’s segments were significantly more likely to have an abnormal OCCD test. 50/608 patients (8.2%) had high-grade dysplasia or cancer on endoscopic biopsies: this equates to 1.3% of the total group (50/3745) . 46/50 patients (92.0%) were deemed high risk, triggering urgent endoscopy: this rose to 100% with insufficient tests removed. There were no cancers diagnosed within 12 months post-OCCD in the low-risk group. Conclusion: OCCD testing is an effective triage tool to identify high-risk patients with Barrett’s oesophagus requiring further investigation with endoscopy within the real-world setting. Introduction Oesophageal adenocarcinoma (OAC) is associated with dismal 5-year survival rates of less than 25%1. Barrett’s oesophagus is a well-established precursor lesion to OAC, in which columnar-lined epithelium demonstrating intestinal metaplasia (IM) replaces the usual squamous epithelial lining of the oesophagus. IM has the propensity to progress through low-grade dysplasia (LGD), high-grade dysplasia (HGD) and intramucosal cancer (IMC), before developing into invasive OAC2. Although the overall estimated an

FAQs

What problem does OCCD testing address in Barrett’s surveillance?

Barrett’s surveillance endoscopy is vital for early cancer detection but creates significant workload for endoscopy services and can be affected by sampling bias and user error. OCCD testing is a minimally invasive alternative intended to improve triage and identify patients needing urgent investigation.

How were high-risk patients defined in the study?

Patients were considered high risk if the OCCD test demonstrated atypia and/or p53 positivity. These risk classifications were then compared against endoscopic histopathology results.

What were the key findings regarding urgent endoscopy and cancer detection?

Among patients undergoing endoscopy within 12 months, 8.2% had high-grade dysplasia or cancer on biopsies, and 92.0% of these were deemed high risk, triggering urgent endoscopy. No cancers were diagnosed within 12 months in the low-risk group.

Sep 21, 2026

Uploaded by Eliana