Cookies on this website

We use cookies to ensure that we give you the best experience on our website. If you click 'Accept all cookies' we'll assume that you are happy to receive all cookies and you won't see this message again. If you click 'Reject all non-essential cookies' only necessary cookies providing core functionality such as security, network management, and accessibility will be enabled. Click 'Find out more' for information on how to change your cookie settings.

In commemoration of World Cancer Day on 4 February 2016, read about two trials involving CSM statisticians on Barrett’s Oesophagus, a precursor to oesophageal cancer that affects over 500,000 UK patients.

The Centre for Statistics in Medicine (CSM) provides statistics support for two large randomised clinical trials on Barrett’s Oesophagus. The condition is a precursor to aggressive, difficult-to-treat oesophageal cancer. Both trials aim to improve how we diagnose, monitor and treat Barrett’s Oesophagus to prevent progression to cancer, and improving the care of over half a million UK patients.

I work in clinical trials because I feel that I can make a difference in the global fight against cancer and improve outcomes for cancer patients using my statistical expertise. New treatments must have the evidence behind them before being introduced into clinical practice.
- CSM Medical Statistician

Oesophageal cancer attacks the food pipe connecting the mouth to the stomach. It is the fastest rising cancer in the developed world, with over 8,000 diagnoses in the UK each year. As this cancer has a 5-year survival of only 15%, with 60% of patients dying within one year of diagnosis, early diagnosis is critical. Barrett’s Oesophagus is one signal we can use to identify those at-risk.

In Barrett’s Oesophagus, the cells lining the oesophagus change, becoming more like intestinal lining cells. Patients with Barrett’s Oesophagus have a higher risk of oesophageal cancer than the general population, as their altered oesophageal cells are prone to developing further abnormalities. These patients are closely monitored and given early interventions to combat the progression to cancer. Any improvements in how these patients are monitored and the treatments used to prevent the development of their disease are helpful.

BOSS is an NHS-HTA-funded randomised trial of 3,453 Barrett’s Oesophagus patients, run throughout the UK. Currently, patients with Barrett’s Oesophagus are given an endoscopy every 2-3 years as a screening measure. A camera is used to check the inside of their oesophagus for any worrying changes. It may be more helpful to instead perform an endoscopy when the patient appears to need one, to spare patients unnecessary invasive tests and reduce costs. The BOSS study will follow trial participants for 10 years to see which of the two approaches works better for them. Trial results are due to be released around 2022.

AspECT, funded by Cancer Research UK, focuses on improving the drug treatment used in Barrett’s Oesophagus to decrease progression to cancer. The drug esomeprazole reduces stomach acid, which can cause the cell abnormalities that characterise the disease. Aspirin can prevent both colorectal and oesophageal cancer. AspECT is investigating which doses of the two drugs together best prevent oesophageal cancer from developing. The final results of AspECT are expected in 2018.

The results from these two trials will offer improved care for over half a million UK patients with Barrett’s Oesophagus. Although it will be a couple of years before we know the primary results, the trials also offer a more immediate benefit. Both trials are gathering information about the characteristics of the patients who suffer from the condition, which will help clinicians to improve diagnosis. The medical community is eagerly awaiting the imminent release of this information, which may inform UK-wide guidelines.

This news item is part of a series on the cancer research conducted and supported by the Centre for Statistics in Medicine, in commemoration of World Cancer Day on 4 February 2016. Read the introduction to the series here, about a little-used trial design that will improve the efficiency of phase I trials here, and about a new trial on pancreatic cancer here.



Similar stories

NIHR Fellowships awarded to NDORMS researchers

Congratulations to Eileen Morrow and Mae Chester-Jones who have received NIHR Doctoral Fellowships

Sara Khalid named Associate Professor at NDORMS

The University of Oxford has awarded the title of Associate Professor to Dr Sara Khalid as part of its recognition of excellence awards.

Botnar researchers awarded Fellowships

Arani Vivekanantham has been awarded an NIHR Doctoral Fellowship and a Versus Arthritis Clinical Research Fellowship, and Rachel Kuo was awarded an NIHR Doctoral Research Fellowship.

Patients like me

What can patients learn from the experiences of people like them who’ve already had a hip replacement? A new tool called ‘Patients like me’ helps answer some of the questions about pain, complications and how long the prosthesis might last.

Daniel Prieto-Alhambra receives ISPE award for COVID-19 research

Daniel Prieto-Alhambra has been awarded the 'Special ISPE award for contributions to public health associated with the COVID-19 pandemic.'

Junqing Xie awarded by the International Society for Pharmacoepidemiology

Congratulations to Junqing (Frank) Xie who has been awarded the Stanley A. Edlavitch Award from The International Society for Pharmacoepidemiology (ISPE).