Beating bowel cancer together

The impact of using lifestyle or genetic information to decide at what age to start inviting people for bowel cancer screening in England

Lead researcher: Dr Juliet Usher-Smith

Location: University of Cambridge

Grant award: £64,995

Dates: July 2018 to June 2019

Research has already shown that the national bowel cancer screening programme can save lives. In this project, Dr Usher-Smith and her colleagues looked at whether more information on lifestyle factors or genes could help improve the screening programme further.

The challenge

At the moment adults are invited to take part in bowel cancer screening based only on their age. However, other factors such as body weight, diet, family history and genes also affect risk of getting bowel cancer.

The science behind the project

This research was done in three parts. For the first stage of the project, the researchers updated their review of research that’s already been done in this area, specifically looking at how the ways of including information about people’s genes (‘models’) can be used to predict risk of bowel cancer. The second stage of the project involved using data from over half a million people in the UK Biobank study, to test how well these models can find people in the UK who get bowel cancer. In the final stage of the project, they used this information alongside details of the bowel cancer screening programme to see the effect of using these models to decide when to invite people to take part.


This was the first study to compare lots of risk models using the UK population in this way. The project suggests that, compared to the current screening programme which only uses age to decide who to invite, including information about lifestyle factors and risk genes could better predict who was likely to develop bowel cancer.

If you like, you can find out more about this work by reading this key research article, published by the researchers.

Other impact

The team have published four papers in scientific journals, and Dr Usher-Smith gave presentations at regional, national and international meetings; these are key ways that their results are being shared with both the research community and policy makers.

They collaborated with the University of Sheffield to develop a model of the English bowel cancer screening programme, to test the effect of risk-based screening. They also worked with Erasmus Medical Centre in Rotterdam to share expertise and access additional data.

Dr Usher-Smith has secured three new grants to continue exploring this area of research, totalling £750,710. This is £11.55 of additional research funding into bowel cancer screening for each £1 that Bowel Cancer UK invested into the project.

What difference will this project make?

This research is a step towards a more personalised approach to screening. It has looked at which models work best to predict risk of bowel cancer and shown that the screening programme could be more effective if this more tailored information was used.

The next step is looking at the costs of this kind of screening programme and if it would save money and reduce the number of people having unnecessary investigations. They will also be exploring the practical and ethical issues around collecting people’s genetic information.

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