Reducing the rates of undetected bowel cancers in England

Lead Researcher: Professor Eva Morris

Location: University of Oxford

Grant award: £149,422

Colonoscopy is the main test used to diagnose bowel cancer, but it isn’t always able to identify every case of the disease. Professor Eva Morris is investigating why some bowel cancers go undetected during a colonoscopy and will explore ways to help reduce the number of undetected cancers in the future.

The challenge

A colonoscopy is a thin tube with a camera on the end, used to look inside the bowel. It is the main test used to diagnose bowel cancer. It can also help to prevent bowel cancer developing in the first place, by removing pre-cancerous growths (known as polyps) that can develop into bowel cancer.

However, no test is 100% reliable and sometimes a cancer (or pre-cancerous growth) is not found during a colonoscopy. This type of cancer is known as a post-colonoscopy colorectal cancer or an undetected cancer.

Bowel cancer is treatable and curable especially if diagnosed early and nearly everyone survives bowel cancer if diagnosed at the earliest stage. Undetected cancers (or pre-cancerous growths) at colonoscopy, can mean that cancers are diagnosed later. Recent research has shown there are a high number of undetected cancers in England and big differences between hospitals.  

The science behind the project

Professor Morris and her team will look 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 then look at all the cases of undetected cancers across all the hospitals to identify the most common reasons for bowel cancers not being found. 

What difference will this project make?

This work will help us to understand more about why some cancers are not detected at colonoscopy. It’s hoped this knowledge can be used to improve colonoscopy services and reduce the numbers of undetected cancers. This would mean more people are diagnosed at an early stage or have pre-cancerous growths removed before the cancer develops, saving lives.

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• Read our blog about recent research highlighting variation in undetected cancers during a colonoscopy 
• Find out more about what to expect when you have a colonoscopy