Moves afoot to prevent bowel cancer
Bowel cancer is the third most common type of cancer in Australia and treating it is both costly and complex. Alarmingly, rates are rising among people aged under 50, and researchers still don’t know why.
Studying polyps Another focus of Mark’s research is improving the follow-up process after a positive screening result. Currently, patients with a positive stool test undergo a colonoscopy, where clinicians look for polyps – small growths in the gut lining that can develop into cancer if not removed. Gastroenterologists and colorectal surgeons remove polyps which are then assessed by pathologists, who examine their size and appearance to determine when the patient should return for a follow-up “surveillance” colonoscopy. But current guidelines as to when this should happen are based on limited evidence and could be improved, Mark says. “Colonoscopies are a massive resourcing problem for the health system and patients can face delays,” he says. To address this, Mark and his team are researching a more personalised way to improve the timing of a colonoscopy for higher risk patients with polyps. Their research involved recruiting patients undergoing a colonoscopy and collecting small biopsies from polyps and nearby healthy gut tissue. These samples were then analysed at a molecular level. “We’ve now identified a number of genes that appear to be linked to higher risk, and this seems to be independent of polyp size” he says.
It is for these reasons that Professor Mark Molloy is on a mission to prevent the disease in the first place. Based in the Kolling Institute and Northern Sydney Local Health District (NSLHD), the leading bowel cancer research specialist is running several projects looking at early detection.
Mark says the first promising pathway is a blood test.
Currently, the main screening method is a government- funded test that detects blood in the stool. The test is mailed to people aged 50-74 years every two years, but Mark says because it requires them to collect the sample themselves, only around 40 per cent return a completed test. “They don’t like handling a stool sample, and early cancers may not leak blood so they can go undetected by this method. So, we’re very interested in whether we can move to a blood test – and not just any blood test,” he says. “We’re working to do this from a few drops of blood collected from a finger prick.” Working with scientists from Sangui Bio, a biotechnology partner of the Kolling Institute, Mark has analysed proteins in blood samples from around 1,200 patients. “We can definitely see a signature in the blood from the finger prick sampling that’s linked to the presence of polyps and early cancers,” he says, adding there is more research to be done.
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