Researchers have found a way to identify people with inflammatory bowel disease (IBD) who are at the highest risk of developing bowel cancer.
IBD, which affects around 500,000 people in the UK, includes ulcerative colitis and Crohn’s disease. They irritate the lining of the bowel, which can cause abnormal pre-cancerous cells to form if left untreated. Having these conditions can increase your risk of bowel cancer, especially if you have had them for several years.
In a study published in the journal Gut, scientists revealed that people with IBD whose pre-cancerous cells had lost or gained multiple copies of their DNA were far more likely to go on to develop bowel cancer.
The study was led by The Institute of Cancer Research (ICR), funded by Cancer Research UK and the Barts Charity and working with doctors at St Mark’s Hospital, the UK’s specialist bowel hospital, and researchers from the University of Oxford’s Nuffield Department of Medicine. One of the co-authors, Professor James East, is supported by the NIHR Oxford Biomedical Research Centre (BRC).
The scientists created an algorithm that calculates the risk of future bowel cancer, based on the exact pattern of the DNA altered in the pre-cancerous cells. They found that this method can predict which people with IBD who develop pre-cancerous cells will go on to develop bowel cancer within five years with greater than 90 percent accuracy.
This method could be used in hospitals to test for bowel cancer risk in people with IBD in the coming years.
Most people with ulcerative colitis or Crohn’s disease will not develop bowel cancer. But those who show signs of pre-cancer in their colon have the difficult choice of regular monitoring or removal of the bowel.
The new test should 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.