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Clinician performing colonoscopy and looking at image on a screen

Bowel Cancer UK is to fund new research at the Nuffield Department of Population Health (NDPH) to look into a wide variation in the detection and treatment rates of bowel cancer in patients in England between different providers. 

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), but it misses some cases. Bowel cancer diagnosed within three years of a colonoscopy is known as ‘post-colonoscopy colorectal cancer’. A new study into such cancers published in the BMJ today found that between 2005 and 2013, colonoscopy screening missed 9,317 bowel cancers. While the rates fell from 9% in 2005 to 6.5% in 2013, the rates were lower in colonoscopies performed as part of the bowel cancer screening programme (3.6%) and higher in independent providers (9.3%). 

Bowel Cancer UK wants to understand the reasons for the differences. With the new funding, Eva Morris, the new professor of health data epidemiology at NDPH, and her team will investigate why post-colonoscopy colorectal cancers occur and ways to reduce rates in future.

Morris said: ‘Our previous work has shown there are many cancers that could have been diagnosed earlier or even prevented. This new project is going to generate the evidence we need to significantly reduce this number and so improve outcomes from this common disease.’ 

Morris and her team will identify cases where bowel cancers went undetected during a colonoscopy and make hospitals aware each time they find a new undetected cancer. The hospitals will then review the cases in detail to understand what happened. 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.  

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.’ 

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