Scientists at the UK’s Institute of Cancer Research (ICR) have developed a method to detect people with inflammatory bowel disease (IBD), who are at risk of developing bowel cancer.

In a recently published study, funded by Cancer Research UK and the Barts Charity, ICR scientists worked with doctors at St Mark’s Hospital, a specialist bowel hospital in the UK.

The study 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.

ICR scientists developed an algorithm that can calculate the risk of future bowel cancer based on the exact pattern of the DNA altered in the pre-cancerous cells.

The new method predicts which people with IBD who develop pre-cancerous cells will develop bowel cancer in the next five years, with greater than 90% accuracy.

The algorithm can be used in hospitals to test bowel cancer risk in people with IBD, in future. 

The Institute of Cancer Research centre for evolution and cancer director, genomics and evolution professor Trevor Graham said: “Crohn’s and ulcerative colitis are common and we need better tools to identify the patients at highest risk of bowel cancer.

“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.”

In the study, scientists collected samples of pre-cancerous cells from 122 IBD patients.

After five years from the sample collection, around half of the patients later developed bowel cancer, while the other half remained cancer-free.

The scientists scanned the DNA samples to identify any changes in the structure and number of copies in the DNA.

They found that IBD patients who developed bowel cancer had lost several copies of DNA.

The test leverages genomic sequencing to check the number of copies of DNA from samples of pre-cancerous growths taken from the gut lining during endoscopy.

The sequencing data would be fed into the algorithm, which calculates their risk based on which copies of DNA are altered, alongside other information.

Other information includes the size of the growth, how easy it was to remove during biopsy and the overall inflammation level of the gut.

Furthermore, the scientists are planning to develop the test beyond analysing samples from the gut to a less invasive method, such as blood samples, in their future studies.

St Mark’s the National Bowel Hospital inflammatory bowel disease research unit lead, and the study co-lead professor Ailsa Hart said: “Patients with inflammatory bowel disease have a higher risk of developing colorectal cancer than people without IBD and need to undergo assessment with regular colonoscopies to try to detect early signs of cancer.

“These tests are onerous and unpleasant for patients, imperfect at detecting early cancer changes and costly to health services.

“If early signs of cancer are detected, surgery, which involves removing the colon, is advocated. Finding smarter ways to assess these colons is much needed.”