Predicting polyps, improving care and reducing bowel cancer risk 

In the UK, bowel cancer screening uses a test called the faecal immunochemical test (FIT). For some people, the results of the test lead to a colonoscopy to look inside the bowel for signs of cancer. During colonoscopies, doctors might spot pre-cancer growths called polyps and remove them – this is known as a polypectomy. But some people go on to develop new polyps, which increases their risk of bowel cancer again. 

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Currently, doctors use information like the number, size, and type of polyps to predict who’s most at risk of developing more and offer follow-up checks. But this method isn’t accurate enough and can misjudge the risk for more than 40% of people. So some people aren’t offered potentially life-saving monitoring, while others have unnecessary colonoscopies.  

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Dr Phillip Dunne and his team, with support from the Bowelbabe Fund for Cancer Research UK, are on the hunt for more accurate biological signs that show who’s at high risk of developing new polyps. In the lab, they’re studying samples of polyps from over 2,600 patients who took part in INCISE, a trial part-funded by Cancer Research UK.  

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The researchers are looking for biological patterns that appear in people who develop more polyps after their polypectomy. And they’re leaving no stone unturned; they’re even looking for risk-revealing clues in healthy tissue surrounding polyps too. 

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Ultimately, the team are aiming to develop tests that spot these patterns using tools already available within the NHS. This will help make sure their research leads to real-world benefits for people at risk of bowel cancer by improving follow-up care and reducing people’s risk of the disease.