Researchers from The Institute of Cancer Research in London have developed a groundbreaking test that could transform the management of inflammatory bowel disease (IBD) by predicting bowel cancer risk with remarkable precision. The new test boasts an impressive accuracy of over 90% in identifying which IBD patients with precancerous cells are likely to develop colorectal cancer within five years. This advancement presents a significant opportunity to tailor surveillance strategies, potentially reducing unnecessary colonoscopies and improving patient outcomes.
Inflammatory bowel disease is a condition that heightens the risk of developing bowel cancer. However, until now, there has been no reliable method to anticipate this risk. The newly developed test is poised to fill this gap, serving as a powerful tool in identifying patients at higher risk and guiding the frequency of their colonoscopies. Trevor Graham, PhD, professor of genomics and evolution and director of the Centre for Evolution and Cancer at The Institute of Cancer Research, played a pivotal role in the study's development.
“People with inflammatory bowel disease are at increased risk of developing bowel cancer, but most IBD patients will not develop cancer. Our new test predicts who really is at risk, so that all patients can be treated in the way that is best for them. Our next steps are to run clinical trials to prove our predictions hold true in real-world settings. Then we hope to be able to offer the test in the NHS in the coming years.” – Trevor Graham, PhD
The test's ability to predict bowel cancer risk allows healthcare providers to customize surveillance schedules. Patients identified as high-risk can receive more frequent colonoscopies, while those deemed low-risk may avoid unnecessary procedures. This personalized approach not only alleviates patient anxiety but also conserves medical resources.
“This is a really great study for the gastroenterologist who follows patients with inflammatory bowel disease to know that there might be a way to identify who’s at higher risk and who’s not.” – Nilesh Vora, MD
In addition to improving patient care, the test holds promise for reducing life-altering surgeries. Currently, surgery is the only effective treatment for those imminently at risk of cancer. However, due to the current inability to accurately assess individual risk, some patients undergo unnecessary surgeries with significant consequences.
“For people who are thought to be imminently at risk of developing cancer, the only effective treatment is surgery to remove some or all of the large bowel,” – Trevor Graham, PhD
“This surgery can be lifesaving. But because we cannot, currently, be sure if someone really does need the surgery, people are having unnecessary surgery which has life changing consequences.” – Trevor Graham, PhD
The next phase involves seeking approval from regulatory bodies like the FDA and conducting clinical trials to validate the test's efficacy in real-world settings. If successful, this innovation could be integrated into routine practice within the National Health Service (NHS) in the coming years.
“In the UK, people with IBD have regular colonoscopies — a camera pushed up their bottom — to look for early signs of cancer,” – Trevor Graham, PhD
“On the other hand, for people whose risk of bowel cancer we think is low and for whom we don’t operate, these people continue to have anxiety about the uncertainty of their cancer risk,” – Trevor Graham, PhD
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