Content Dam Diq Online Articles 2015 05 Cytosponge Bmj Thumb

Introduction: Swallowing a sponge on a string could help detect oral cancer, and turmeric antioxidant shows treatment promise

May 14, 2015
A new, minimally invasive test using a small sponge and string may help doctors diagnose GERD and Barrett's esophagus without risky surgery. Also, curcumin may slow or surpress the action of the HPV virus, and a Canadian study found that vaccinating boys prevented oral head and neck cancer later.

April was Oral Cancer Awareness Month, but we need to be aware of prevention, early diagnosis, and treatment of oral cancer every day. On that note, according to data based on the Canadian health system, extensive vaccination of boys for the human papillomavirus (HPV) vaccine to prevent infection was demonstrated to be a cost-saving measure that prevented later head and neck cancer. (1) According to MedPage Today, a 70% immunization rate and 99% efficacy with the quadrivalent vaccine Gardasil might reduce costs by as much as $28 million (US $22.2 million). (2)

Keeping with the theme of HPV and oral cancer, curcumin, an antioxidant found in turmeric, was reported to slow or suppress the action of the HPV virus. (3) According to the study authors, turmeric has recognized antiviral and anti-cancer capabilities. (4) They said the study verified that curcumin is “not only a powerful inhibitor for the activity of host nuclear transcription factors AP-1 and NF-kB but it also selectively suppresses transcription of the HPV16/E6 oncogene during the carcinogenic process in oral cancer cells.” (4) This may lead the way for new studies and a possible new therapy for HPV-infected oral cancers.

Figure 1: A cytosponge in gelatin capsule (right) and expanded (left). Source.

Another investigation revealed a novel, minimally invasive test that can be used to help identify individuals with gastroesophageal reflux disease (GERD) and Barrett's esophagus. (5) The study assessed the safety, acceptability, and accuracy of the new test compared to endoscopy. During the test, the patient swallows a small capsule on a string that expands to form a small sponge in the stomach (figure 1). The string is then carefully pulled out and referred for testing to see if there are any signs of cancer in the cells lining the esophagus. While the test results were positive, randomized controlled trials are needed to evaluate its appropriateness for clinical implementation.

We also discuss dental caries and children in this issue. A new study titled “Global Burden of Untreated Caries" was recently published. (6) The authors stated that the conclusions have important implications for oral health policy and planning health services. Untreated dental decay presents a formidable public-health challenge in most countries in the world, and is the fourth-most expensive chronic disease to treat. (6) They also found that untreated decay is moving from children to adults. Their conclusion was that untreated caries in permanent teeth continues to be the most widespread health condition across the world in 2010, with 2.4 billion people affected, and untreated caries in deciduous teeth was the 10th most prevalent condition, affecting 621 million children globally. (6)


Maria Perno Goldie

1. Graham DM, Isaranuwatchai W, Habbous S, et al. A cost-effectiveness analysis of human papillomavirus vaccination of boys for the prevention of oropharyngeal cancer [published online ahead of print April 13, 2015]. Cancer. 2015. doi: 10.1002/cncr.29111.
2. Bankhead C. HPV shots for boys might cut cancer costs. Medpage Today. Published April 13, 2015. Accessed May 14, 2015.
3. Curry: Curcumin offers potential therapy for cancers caused by HPV. ScienceDaily. Published April 23, 2015. Accessed May 14, 2015.
4. Mishra A, Kumar R, Tyagi A, et al. Curcumin modulates cellular AP-1, NF-kB, and HPV16 E6 proteins in oral cancer. Ecancermedicalscience. 2015;9:525. doi: 10.3332/ecancer.2015.525.
5. Ross­Innes CS, Debiram­Beecham I, O'Donovan M, et al. Evaluation of a minimally invasive cell sampling device coupled with assessment of trefoil factor 3 expression for diagnosing Barrett's esophagus: A multi­center case-control study. PLoS Med. 2015;12: e1001780. doi: 10.1371/journal.pmed.1001780.
6. Kassebaum NJ, Bernabé E, Dahiya M, Bhandari B, Murray CJ, Marcenes W. Global burden of untreated caries: A systematic review and metaregression. J Dent Res. 2015;94:650-658.