A new test to predict which people with inflammatory bowel disease will get bowel cancer

Lead researchers: Dr Annie Baker and Professor Trevor Graham 

Location: Institute of Cancer Research, London and St Mark’s Hospital, London 

Grant award: £164,916 

Dr Baker and Professor Graham are developing a non-invasive way to predict bowel cancer risk in people who have inflammatory bowel disease (IBD). 

The challenge 

People with inflammatory bowel disease have a higher risk of developing bowel cancer. Every few years they have a colonoscopy to check their bowel for the early signs of cancer, and if found these can be surgically removed.

Only a small proportion of people with IBD will develop bowel cancer, but everyone needs to have the regular colonoscopies. These procedures are essential but time-consuming, uncomfortable and place high demand on NHS services. 

It would be very helpful to be able to predict which IBD patients are at less risk and don’t need to be monitored in this way.

The science behind the project

Dr Baker and Professor Graham’s lab have already done important research in this area. They studied bowel tissue from IBD patients and found changes in the DNA that can signal when cells are starting to behave abnormally. They showed that these DNA changes can be used to identify people who will develop cancer in the next five years.

This is an exciting step forward for helping people with IBD to manage their disease. However, as that new test currently uses bowel tissue, it still requires a colonoscopy.

Now, the researchers are investigating if they can detect the same DNA changes in blood or poo. IBD patients who are attending their routine hospital appointments will be asked to provide samples for the study.

What difference will this project make? 

For people living with IBD, knowing more about their bowel cancer risk helps them, and their healthcare teams, to make informed decisions about their disease and how best to manage it.

If the same DNA changes found in bowel tissue can be picked up in blood or poo, it'll give a much less invasive way to test people with IBD for their bowel cancer risk. Patients will only need to have some blood drawn, or provide a poo sample, rather than having a colonoscopy.

This will save patients from having unnecessary procedures, and free up colonoscopy capacity for where it’s really needed.

• For more information see our announcement of the grant
• Read more about their previous research in this area
• Donate to help make our research possible

“Cancer risk prediction in inflammatory bowel disease is a significant clinical challenge. Many IBD patients undergo unnecessary procedures, whilst in others the early signs of bowel cancer are missed. Research in our team has strived to address this for many years. This project grant from Bowel Cancer UK is particularly important for my career as it will enable me, for the first time, to take a leading role in driving this research towards an assay [test] that could ultimately improve the lives of IBD patients, a cause that I am deeply passionately about.” - Dr Annie Baker 

"People who have inflammatory bowel disease have an increased risk of developing bowel cancer, and so are offered regular screening to spot early signs of cancer. With this new funding from Bowel Cancer UK we aim to produce a blood test, and also a stool test, that can spot early signs of cancer just as well as colonoscopy. We hope that this will mean that, in the future, people with IBD can have fewer colonoscopies: only when they really need to" - Professor Trevor Graham