27th July 2026

Landmark “pill-on-a-thread” cancer screening trial opens in Wales

This article originally featured on Health and Care Research Wales.

A landmark clinical trial of a “pill-on-a-thread” test that could help transform the early detection of oesophageal cancer and reduce pressure on NHS services has opened in Wales today.

The BEST4 Screening Trial will find out if the capsule sponge test could be used to screen people with heartburn for Barrett’s oesophagus – a condition that can lead to oesophageal cancer.

The test takes around ten minutes and can be carried out by a nurse, helping identify people who may need further investigation without the need for an invasive endoscopy. By identifying people at risk earlier, the test could enable more timely treatment, improve outcomes, and reduce pressure on endoscopy services.

The UK trial is backed by £6.4 million of funding from Cancer Research UK and the National Institute for Health and Care Research (NIHR). In Wales, the study is funded by Welsh Government, coordinated by Health and Care Research Wales, and delivered using mobile screening vans to bring research closer to communities across the country.

In Wales, approximately 1,322 new cases of oesophago-gastric cancer (which includes oesophageal cancer) were diagnosed in patients between April 2021 and March 2023. Oesophageal cancer is the seventh most common cause of cancer death in the UK, with around 22 deaths a day from the disease.

Over the next three years, the Best4 trial will recruit 120,000 people across the whole of the UK who regularly take medication for heartburn – which is the most common symptom of Barrett’s oesophagus, a condition in which cells in the food pipe start to grow abnormally.

The trial showcases Wales’ research opportunities and is the last step in a series of clinical trials to see if the capsule sponge test could be offered in the cancer screening programmes of the four UK nations.

How to take part

Invitations to take part in the trial are being sent by text message from NHS Wales, encouraging as many eligible people as possible across Wales to get involved. To take part, people must first join Heartburn Health, a programme that helps identify people who may be eligible for research studies into conditions linked to chronic heartburn.

Eligible people can join Heartburn Health through the NHS Wales text message invitation or by visiting www.heartburnhealth.org.

The BEST4 Screening Trial is open to men aged 55–79 and women aged 65–79 who are currently taking medication for chronic heartburn.

More information about the trial can be found on the BEST4 Screening Trial website, www. best4trial.org, or by emailing cuh.best4screening@nhs.net or calling 0808 281 4772.

Irene Debiram-Beecham, Principal Research Nurse and BEST4 Clinical Coordinator, said:

“We’re delighted to be bringing the BEST4 Screening Trial to communities across Wales. The capsule sponge test is quick and straightforward, taking around ten minutes and carried out by a trained nurse.

“By using mobile screening units, we’re making it easier for people to take part closer to home. Every person who joins the study will help us understand whether this approach could play a role in identifying people at risk of oesophageal cancer earlier in the future.

“If you receive an invitation, we encourage you to consider taking part and helping us build the evidence needed to improve care for future generations.”

Professor Rebecca Fitzgerald, inventor of the capsule sponge test and Chief Investigator of the BEST4 trials, said:

“The BEST4 Screening trial is the pinnacle of many years of painstaking research, which has demonstrated that the capsule sponge can reliably identify Barrett’s oesophagus.”

“Thousands of people have already benefited in trials and pilot programmes, and now we’re taking the test to the next level to see if we could offer this to everyone with heartburn.”

“The BEST4 Screening trial could fundamentally transform the lives of people affected by oesophageal cancer by providing the crucial evidence needed to make it a viable screening programme, rolled out to every part of the UK.”

Dr Nicola Williams, National Director of Support and Delivery, Health and Care Research Wales said:

“BEST4 is an exciting example of how innovative research can be brought directly into communities, making it easier for people to take part in studies that have the potential to improve lives.

“By using mobile screening vans and new approaches to identifying people at risk, this trial will help reach people closer to home while generating evidence that could reduce pressure on NHS services in the future.

“We are proud to support a study that will help shape the future of screening for people across Wales and beyond.”