60 Long-Term Follow-Up Outcomes in Low and Moderate Risk Patients Previously Undergoing Capsule Sponge Testing for Barrett’s Surveillance

Abstract Aim While capsule sponge testing for Barrett’s surveillance has garnered increasing popularity, its ongoing use has been hindered by the 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 initially undergoing Barrett’s surveillance with capsule sponge testing within the CytoSCOT programme. Method Patients with a previous capsule sponge test for Barrett’s surveillance demonstrating TFF3 positivity or negativity only between 14/9/2020 and 31/12/2021 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 (+/- endoscopy). 2.2% of patients had low grade dysplasia (LGD), 1.3% had high grade dysplasia (HGD), 0.3% had intramucosal adenocarcinoma (IMC) and 0.1% of patients had oesophageal adenocarcinoma (OAC) on endoscopic biopsies. There were no statistically significant differences in the rates of HGD, IMC and OAC in the endoscopy only versus repeat capsule sponge test groups. Traditional endoscopy detected more cases of indefinite for dysplasia (IND) (4.2% vs. 0.9%; p=0.012) and LGD (3.6% vs. 0.9%; p=0.032) versus repeat capsule sponge testing. Conclusions While long-term follow-up results are promising for patients previously undergoing Barrett’s surveillance with capsule sponge testing, further robust evidence is required before clinical guidelines can be modified.