New study shows variation in bowel cancer rates after colonoscopies in England

A new study published in The BMJ today (Thursday 14 November) shows wide variation between colonoscopy providers in England, meaning some people are having their cancers undetected or not prevented. 

Colonoscopy is the main test used to diagnose bowel cancer and it can also help to prevent the disease by removing pre-cancerous growths (known as polyps). However, the test isn’t always able to identify every polyp or bowel cancer. Bowel cancer diagnosed within three years of a colonoscopy is known as ‘post-colonoscopy colorectal cancer’.

This study looked at post colonoscopy colorectal cancer rates in England between 2005 and 2013 and found that during the study period 9,317 bowel cancers were either not detected or not prevented. Although rates improved from 9% overall in 2005 to 6.5% in 2013, there was significant variation between colonoscopy providers. The rates were lower in colonoscopies performed as part of the bowel cancer screening programme (3.6%) and higher in independent providers (9.3%).

Dr Lisa Wilde, Director of Research and External Affairs at Bowel Cancer UK said: “It is clear from the research that variation between colonoscopy providers in England must be reduced. Whilst it’s encouraging that there has been some improvement, the research suggests that between 2005 to 2013 almost 4,000 bowel cancers could have been prevented or diagnosed earlier if colonoscopy providers matched the lowest rates of post colonoscopy colorectal cancers seen in the study.

Recognising and highlighting variation in colonoscopies is key, but research is needed to understand why this variation is happening. That’s why Bowel Cancer UK is delighted to be funding the lead researchers of this study to investigate why post colonoscopy colorectal cancers occur and explore ways to help reduce them in the future. This is a vital step in driving improvements in colonoscopy services that will help improve early diagnosis and prevention of bowel cancer, and ultimately save lives.”

In research we’re funding, which we’re pleased to announce today, Professor Eva Morris and her team at the University of Oxford will be looking at data from hospitals in England to identify cases where bowel cancers went undetected during a colonoscopy. The researchers will link this data, so that each time a new undetected cancer is found, the hospital is made aware of it.

They will ask each hospital to review any undetected cancer cases in detail. This review process will help the hospital to understand what happened and why the cancer was not found. The research team will look at the cases of undetected cancers across all the hospitals to identify the most common reasons for bowel cancers not being found. 

This award is part of our investment of over £1.3 million pounds to support research with the greatest benefits for those at risk and affected by the disease.

• Find out more about what to expect when you have a colonoscopy

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