A new test to identify people with inflammatory bowel disease with the highest risk of bowel cancer is more than 90 percent accurate, research has shown.
People with inflammatory bowel disease (IBD), including Crohn’s and ulcerative colitis, are known to be at an increased risk of bowel cancer, although not all will experience it.
Scientists at the Institute of Cancer Research (ICR) have developed a new DNA testing method to determine which people with IBD have the highest risk of bowel cancer.
The team now wants to develop the technology into a test for to improve how doctors respond to bowel cancers linked to Crohn’s, ulcerative colitis and other types of IBD.
ICR Professor Trevor Graham said: “Most people with ulcerative colitis or Crohn’s disease won’t develop bowel cancer.
“But for those that have these conditions and are showing signs of pre-cancer in their colon, there are some tough decisions to make.
“Either they have it monitored regularly, in the hope it doesn’t become cancer, or they have their bowel removed to guarantee they don’t get cancer in the future. Neither of these options are particularly pleasant.”
Cancer Research UK, which backed the research, said the new approach should mean fewer people with IBD will need to undergo surgery or regular colonoscopies to lower or gauge their risk of cancer.
About half a million people in the UK have IBD, with Crohn’s and ulcerative colitis the most common types. Both conditions can sometimes cause pre-cancerous cells to form because they irritate the lining of the bowel.
Some three in 10 people with these abnormal cells will go on to develop bowel cancer within 10 years and before the study it was hard to tell who they might be.
Once the new test becomes available it should mean fewer people with IBD have to face the choice of regular monitoring or bowel removal, according to Cancer Research UK.
Professor Graham said: “Our test and algorithm give people with IBD, and the doctors who care for them, the best possible information so that they can make the right decision about how to manage their cancer risk.
“We can accurately identify those people at high risk whilst putting the minds of many others at rest.”
To determine people’s cancer risk, scientists at the ICR teamed up with doctors at St Mark’s, the UK’s specialist bowel hospital.
They found people with IBD whose pre-cancerous cells had lost multiple copies of their DNA were much more likely to develop bowel cancer.
The scientists created an algorithm which can calculate the risk of developing bowel cancer, based on the exact pattern of DNA changes in the pre-cancerous cells.
Craig Foster, from Waterlooville, lost his wife Fariba to bowel cancer in February last year. A dental receptionist, Fariba had lived with ulcerative colitis since she was 18, when she had three-quarters of her bowel removed to help manage the condition.
Mr Foster said: “Research like this will save lives. It gives me comfort to know there are scientists working right now so no-one has to experience the same situation Fariba was in.”
Dr Iain Foulkes, Cancer Research UK’s Executive Director of Research and Innovation, said genome sequencing is changing how experts look at cancer.
He said: “Getting a full readout of tumour DNA means we can see a much bigger picture of how someone’s cancer started and how it is likely to change over time.
“With this research, we can focus resources on treating people with IBD who are at really high risk, saving health services valuable time and money. We can also give those at lower risk peace of mind and remove the fear of bowel cancer in the future.”
