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Nearly 16,000 checks, 4,669 endoscopists, and the three things that found more polyps

Qurexa Editorial Team28 October 20266 min read 0 0
Nearly 16,000 checks, 4,669 endoscopists, and the three things that found more polyps

What happened

On Tuesday 27 October 2026, the University of Edinburgh published the findings of the first UK-wide study of how well bowel cancer checks are carried out in people with inflammatory bowel disease. Inflammatory bowel disease, usually shortened to IBD, covers Crohn's disease and ulcerative colitis. Both cause long-term inflammation in the gut. That inflammation, over many years, raises the risk of bowel cancer. Because of that risk, people with IBD are offered regular camera checks of the bowel. These are called surveillance colonoscopies. They are not the same as the national bowel cancer screening programme that sends test kits through the post. They are a separate, specialist check for a higher-risk group. The research team used the National Endoscopy Database, which collects information from around 65% of UK endoscopy units. They looked at almost 16,000 of these procedures carried out in 2024, performed by 4,669 endoscopists. The study was published in the Journal of Crohn's and Colitis. It involved clinicians and researchers from NHS organisations and universities across all four UK nations. The team describe it as the largest analysis of its kind anywhere in the world.

Why this matters

About half a million people in the UK live with Crohn's disease or ulcerative colitis. For many of them, these checks are a regular part of life for decades. The point of a surveillance colonoscopy is to find polyps. Polyps are small growths in the lining of the bowel. Most are harmless, but some can turn into cancer over time. Finding and removing them early is how the check does its job. If some checks are better at finding polyps than others, then where you have your check, and who does it, starts to matter. That is not a comfortable thought, and it is exactly why a national picture was needed. One finding stands out. Fewer than one in five of the endoscopists in the study did these IBD checks at least once a month. Yet that small group carried out 57% of all the procedures. In other words, the majority of this specialist work is done by a minority who do it regularly, while a long tail of clinicians do it only occasionally. Dr Shahida Din of the University of Edinburgh's Institute of Genetics and Cancer, who led the study, put her finger on the structural reason. She noted that IBD cancer checks are important, but unlike organised bowel cancer screening they do not have the same protected capacity. Screening programmes get ring-fenced lists, trained staff and set standards. IBD surveillance largely does not.

What the evidence actually says

Three things were linked with finding more polyps. The first was regular experience. Checks done by people who perform them often were associated with higher polyp detection. The second was time. Procedures that allowed more time were associated with finding more. The third was dye. Using a special dye that coats the bowel lining and makes flat or subtle changes easier to see was also associated with higher detection. This technique is sometimes called chromoendoscopy. None of that is surprising to anyone who does the job. What is new is that it has now been measured across the UK rather than in one hospital. Now the honest limits. This is an observational study. It shows associations, not proof of cause. The database did not include the laboratory results for the polyps that were removed, so the researchers could not tell whether these differences actually lead to fewer cancers or fewer deaths. That is a significant gap, and the authors say so plainly. It also covers around 65% of UK endoscopy units, not all of them, and a single year of data. Dr Din said further research should establish whether more consistent pathways and dedicated time improve detection of precancerous changes. That is the right next question. What this study gives the NHS is a starting point for measuring and improving IBD care, which did not exist before.

Practical advice

If you have Crohn's disease or ulcerative colitis, here is what is useful to do with this. Keep your surveillance appointments. The single biggest risk is a check that never happens. If you have been invited and have not gone, contact the department and rebook. If you are not sure whether you should be on a surveillance programme, ask. Eligibility depends on how long you have had the condition, how much of the bowel is affected, and other factors such as a family history or primary sclerosing cholangitis. Your IBD team can tell you. It is entirely reasonable to ask questions before a procedure. You might ask how often the person doing it performs IBD surveillance checks, and whether dye will be used. Asking is not rude. Services that are confident in their quality will not mind. Follow the bowel preparation instructions carefully. A poorly prepared bowel is one of the commonest reasons a check has to be cut short or repeated. Do not wait for a scheduled check if something changes. New or different bleeding, a persistent change in bowel habit, unexplained weight loss or new tummy pain should be reported to your IBD team or GP now, not at your next appointment. Keep taking your maintenance medicines. Controlling inflammation over the long term is itself part of lowering cancer risk.

What to know

The first UK-wide analysis of bowel cancer surveillance in people with IBD looked at almost 16,000 procedures from 2024, carried out by 4,669 endoscopists, using data from around 65% of UK endoscopy units. Regular experience, more time for the procedure, and using a dye to improve visibility were each linked with finding more polyps. Fewer than one in five endoscopists did these checks at least monthly, yet they performed 57% of them. The study could not show whether these differences lead to fewer cancers, because polyp laboratory results were not in the database. More research is needed. For patients, the practical message is unchanged and simple: attend your surveillance appointments, report new symptoms promptly, and keep taking the medicines that keep inflammation under control. Sources: News-Medical, 'UK study identifies ways to improve bowel cancer detection in IBD patients', 27 October 2026, https://www.news-medical.net/news/20261027/UK-study-identifies-ways-to-improve-bowel-cancer-detection-in-IBD-patients.aspx ; Pohl K et al., 'UK national analysis of colonoscopy quality in inflammatory bowel disease surveillance: a National Endoscopy Database (NED) cohort study', Journal of Crohn's and Colitis, 2026, DOI 10.1093/ecco-jcc/jjag126, https://doi.org/10.1093/ecco-jcc/jjag126 ; EurekAlert (University of Edinburgh), 'Improve IBD bowel checks for early cancer detection, study finds', 27 October 2026, https://www.eurekalert.org/news-releases/1149447 This article is for general information and does not replace advice from a doctor, pharmacist or other qualified healthcare professional. If you have IBD, discuss your surveillance plan with your own IBD team.

#inflammatory bowel disease#bowel cancer#colonoscopy#NHS#research#Crohn's and colitis

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