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Surveillance strategies or chemoprevention of clinically diagnosed Barrett’s oesophagus are unlikely to alter population mortality from oesophageal adenocarcinoma since it is estimated that only 5% patients with Barrett’s oesophagus are diagnosed, despite the increasing use of endoscopy.1 Endoscopic screening for Barrett’s oesophagus in white men aged over 50 years with chronic heartburn has therefore been advocated in the US.2 However, the prohibitive cost of endoscopy and the pathological expertise required make this screening programme problematic.
The aim of this study was to develop a screening test that did not rely on endoscopy and would be applicable to primary care. A non-endoscopic cytological test, which has been successfully used for the diagnosis of oesophageal squamous carcinomas in high-risk areas, was adapted by combining it with immunocytology. The device (bought from Nanru Technologies, Bellville, South Africa) consists of a sponge …
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