A new UK-wide study has looked at how bowel cancer screening checks are carried out for people with inflammatory bowel disease (IBD), and has identified factors that may help doctors spot early warning signs more effectively. The findings could help make these important checks more consistent across the country, which may benefit the thousands of people living with Crohn’s disease or ulcerative colitis who face a higher risk of bowel cancer.
Why regular checks matter
People with IBD affecting the large bowel are known to have a higher chance of developing bowel cancer over time. To catch early changes, they are offered regular camera examinations called endoscopies, which allow doctors to look inside the bowel and remove any small growths, known as polyps, before they have a chance to develop into cancer. Unlike the national bowel cancer screening programme, these IBD checks are usually fitted in alongside other hospital procedures, which researchers say can make it harder to plan consistent, dedicated care.
What the researchers found
The study, led by the University of Edinburgh, is described as the largest analysis of its kind in the world. The team examined records from the National Endoscopy Database, covering around 65 per cent of endoscopy units across the UK. This included close to 16,000 procedures carried out during 2024 by 4,669 different endoscopists, the specialists who perform these checks.
How often the specialist performs the checks
The researchers reported that fewer than one in five endoscopists carried out these procedures at least once a month, yet this small group was responsible for more than half of all the checks performed. Doctors who performed the examinations more regularly were more likely to find polyps during the procedure.
Time allowed for the procedure
The study also found that when more time was set aside for the examination, more polyps were detected. This suggests that rushed appointments may make it harder to spot smaller or less obvious changes in the bowel lining.
Use of a special dye
Using a special dye during the procedure, which helps highlight changes in the bowel lining, was also linked to higher rates of polyp detection compared with checks carried out without it.
Why this matters for patients
According to the study authors, these findings offer a useful starting point for measuring and improving the quality of IBD bowel checks across the UK. The researchers suggest that more consistent appointment scheduling and protected time for specialists with regular experience in these procedures could potentially support earlier detection of changes that may otherwise be missed.
What to keep in mind
The research team was clear about the limits of the study. The database did not include laboratory results for the polyps that were removed, so it is not yet possible to say whether these differences actually led to fewer bowel cancers being diagnosed later on. Dr Shahida Din, the study’s principal investigator from the University of Edinburgh, said further research is needed to establish whether more consistent pathways and dedicated time genuinely improve the detection of changes that could become cancerous, and ultimately patient outcomes. The study does not suggest that patients should change how or when they attend their existing appointments.
Reference
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.
This article is a journalistic summary for informational purposes only. It does not constitute clinical advice or a recommendation to alter treatment decisions.