Early Diagnosis and Prevention of Colorectal Disease

Early diagnosis is a powerful way to improve cancer survival. Investigative techniques need to be performed well to maximise performance and tolerability.

Early diagnosis and prevention of disease are two areas in which research is being undertaken because it has been established that one of the best ways to improve cancer survival rates is early diagnosis of the disease.

Unfortunately, at this time, medicine is poor at assessing individual risks. New genetic technologies and knowledge will allow personalised risk stratification for these patients. St Mark’s medical staff have already implemented genetic medicine into the clinical setting, and new technologies will vastly widen the scope of this.

The research undertaken at St Mark’s is already identifying and managing individuals at high risk of colorectal cancer. This process will soon expand to include those who are identified as having a moderate risk. Furthermore, employing genetic medicine to stratify an individual’s risk will allow for personalised surveillance regimes and a more tailored treatment plan.

St Mark’s is uniquely placed in this field because

  • It is a world leader in understanding inherited colorectal cancer, hosting the world’s oldest and largest Poplyposis Registry
  • It is home to a regional family cancer clinic
  • St Mark’s is integrating genetic information in to its clinical practice
  • The Wolfson Unit for Endoscopy is recognised as a world centre of excellence
  • St Mark’s has the longest running IBD surveillance programme, designed to detect cancer at the earliest stage
  • An established track record in the translation of new advances into clinical practice

Recent Research


CT colonography (CTC) is a less invasive alternative to traditional colonoscopy to identify pre-cancerous and cancerous growths, however, accuracy levels for identifying these growths vary significantly across the UK. PERFECTS was a collaboration between St Mark’s and the radiology faculty at University College London Hospitals to address the UK-wide variability in CTC scan reporting.

PERFECTS robustly tested a training model which has had real world impact; the interest generated has led to the development of the national CTC training and accreditation programme, funded by Health Education England and 40tude. The programme includes the core PERFECTS term in addition to collaborators from radiology departments across the UK and is aimed at radiologists and radiographers whose roles are vital for more accurate CTC scan reporting. Its aim is to formally introduce CTC into the national Bowel Cancer Screening Programme alongside FIT and endoscopy. The team look forward to continuing their work and are grateful to the donors that contributed to PERFECTS which has led to the development of the national programme.