More than 450,000 people are diagnosed with esophageal cancer (EC) each year and around 400,000 die annually from the disease. In the past three decades, EC incidence rates increased by six fold, making EC the fastest rising cancer in the Western World. This severe increase is closely associated with modern lifestyle and its concomitants such as alcohol consumption, higher age, obesity, and, in particular, a pre-cancerous condition called Barrett’s esophagus (BE), affecting around 10 million people in the Western countries. All these predispositions may lead to EC if not detected and treated early on.
Unfortunately, EC is often detected late leading to the high mortality rates mentioned above. In fact, the 5-year survival rate is only 10% if detected late while it significantly increases to 90% upon early diagnosis. The current situation of late EC detection is largely based on the lack of adequate detection methods.
In recent times, EC detection typically relies on white-light endoscopy (WLE), i.e. the visual inspection of the esophagus through an optical system (endoscope) and subsequent pathological analysis of biopsied samples. Human vision, however, is insensitive to detecting early disease and lacks specificity and staging ability, compromising disease prognosis and thus, is often inaccurate and may miss lesions.
The interdisciplinary research team of ESOTRAC developed an innovative endoscope that combines sensing of pathophysiological tissue signatures resolved by multi-spectral optoacoustic tomography (MSOT) with morphological disease parameters provided by optical coherence tomography (OCT). The novel endoscope has superior qualities in detecting early stages of EC compared to WLE, e.g. by not only inspecting the esophageal surface but screening for abnormalities hidden inside the tissue. The hybrid endoscope generates three dimensional images of the esophagus at high resolution, allowing physicians to inspect the entire esophagus wall and to detect early onset of cancer within the mucosa/submucosa, which in turn, will reduce unnecessary biopsies.
Moreover, the socio-economic impact of our hybrid endoscope can become immense. Treating late disease incurs average costs of €130,000 per patient putting esophageal cancer amongst the most expensive treatments in oncology today. A 5% shift from late-detections to early-detections would result in €2.7 billion savings; with a 10% shift, this number would rise to €5.4 billion.
