Groundbreaking new test 90% accurate in finding patients at high risk of bowel cancer
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Scientists believe a groundbreaking new test may predict patients at high risk of developing bowel cancer with 90 per cent accuracy.
Research, published in the journal Gut on Thursday, could lead to blood testing for the thousands of Britons with irritable bowel diseases (IBD) ulcerative colitis or Crohn’s who were most at risk of developing bowel cancer, and help avoid some invasive procedures.
There are about 500,000 people living in the UK with ulcerative colitis or Crohn’s, according to the charity Crohn’s and Colitis UK, and bowel cancer is the fourth most common cancer in the UK according to Cancer Research UK.
Director of the centre for evolution and cancer at The Institute of Cancer Research, Professor Trevor Graham, said most people living with those diseases would not develop bowel cancer as a result, but the options for those showing signs of pre-cancer were tough.
“Either they have it monitored regularly, in the hope that it doesn’t become cancer, or they have their bowel removed to guarantee they don’t get cancer in the future. Neither of these options are particularly pleasant,” he said.
“Crohn’s and ulcerative colitis are common and we need better tools to identify the patients at highest risk of bowel cancer.”
Scientists from the Institute of Cancer Research worked with St Mark’s Hospital to get samples of pre-cancerous cells from 122 patients with IBD.
Within five years, about half had developed bowel cancer, and the researchers worked out those whose cancerous cells had lost or gained multiple copies of their DNA were far more likely to develop bowel cancer. The scientists then created an algorithm to calculate the risk of future bowel cancer based on the pattern made by the altered DNA.
Prof Graham said: “Our test and algorithm give people with IBD, and the doctors who care for them, the best possible information so that they can make the right decision about how to manage their cancer risk. We can accurately identify those people at high risk whilst putting the minds of many others at rest.”
Craig Foster lost his wife Fariba to bowel cancer in February 2024. She had lived with ulcerative colitis, and had three-quarters of her bowel removed when she was 18.
Mr Foster said the research, which was funded by Cancer Research UK and the Barts Charity, had the potential to save others in Fariba’s position.
“Cancer takes no prisoners and it doesn’t matter who you are or from what walk of life, everyone is affected in some way. Fariba died just six months after she was diagnosed. Even though it was a short time, it was the worst time,” he said.
“Research like this will save lives. It gives me comfort to know that there are scientists working right now so that no-one has to experience the same situation Fariba was in.”
Study co-lead Professor Ailsa Hart said the hope was this finding would reduce the need for invasive testing for at-risk patients.
“Patients with inflammatory bowel disease have a higher risk of developing colorectal cancer than people without IBD, and need to undergo assessment with regular colonoscopies to try to detect early signs of cancer. These tests are onerous and unpleasant for patients, imperfect at detecting early cancer changes and costly to health services,” she said.
“If early signs of cancer are detected, surgery, which involves removing the colon, is advocated. Finding smarter ways to assess these colons is much needed.”
Prof Hart, who also leads the inflammatory bowel disease research unit at St Mark’s the National Bowel Hospital, said this work could be “readily translated” into practice and help patients with IBD and early cancer signs make decisions about surgery.
Executive Director of Research and Innovation at Cancer Research UK, Dr Iain Foulkes, said bowel cancer treatment is “far more likely” to be effective if the disease is caught early.
“With this research, we can focus resources on treating people with IBD who are at really high risk, saving health services valuable time and money. We can also give those at lower risk peace of mind and remove the fear of bowel cancer in the future,” he said.
