BJS 1 - Endoscopic histopathology results in patients undergoing oesophageal cell collection device and biomarker testing for Barrett’s oesophagus surveillance

Abstract Aims Barrett’s oesophagus surveillance places significant burden on endoscopy services, yet is fundamental 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 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 using Cytosponge(TM) 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 categorise 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 Barrett’s OCCD tests were performed in 3745 patients: 608 patients had an 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 (p<0.001). 50/608 patients (8.2%) had high grade dysplasia or cancer on endoscopic biopsies: this relays 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 missed cancers within 12 months of OCCD test in our cohort. Conclusions OCCD testing is an effective triage tool to identify high-risk Barrett’s surveillance patients requiring further investigation with urgent UGI endoscopy within the real-world setting.