Brush cytology technique in the detection of oesophageal carcinoma in the asymptomatic, high risk subject; a pilot survey

This study assesses the reliability of abrasive brush cytology in the diagnosis of early cancer of the oesophagus among asymptomatic rural Ciskeians. An inexpensive locally manufactured brush biopsy capsule was used to obtain cytological material from 1336 subjects; 59% of them were brushed a second time. The technique appears to have a high sensitivity (90%) and specificity (99.9%). Three of five asymptomatic subjects diagnosed as having early oesophageal cancer refused further treatment, indicating the importance of health education as a prerequisite to the introduction of a screening programme for oesophageal cancer.