UK Study Finds Experience, Time and Dye Linked to Better Polyp Detection in IBD Bowel Checks

A team led by the University of Edinburgh has produced the first UK-wide look at how bowel cancer checks are carried out for people with inflammatory bowel disease, and the picture it draws is of a service resting on a small number of hands. The study, described as the largest of its kind anywhere in the world, appears in the Journal of Crohn's and Colitis.

The background is straightforward. People with IBD, including those with Crohn's disease or ulcerative colitis affecting the large bowel, face a higher risk of bowel cancer. Regular camera checks, known as endoscopies, can pick up early changes. But these checks are usually slotted in alongside other hospital procedures, which makes consistent care harder to plan.

To see how the checks are actually delivered, the researchers turned to the National Endoscopy Database, which covers about 65 per cent of UK endoscopy units. They examined almost 16,000 procedures carried out in 2024 by 4,669 endoscopists, the professionals who perform the tests. The aim was to find which factors were associated with detecting polyps, small growths some of which may be precancerous.

The first finding concerns who is doing the work. Fewer than one in five endoscopists performed these checks at least monthly, yet that group carried out 57 per cent of all the procedures. A small proportion of the workforce, in other words, is handling more than half of the cases.

The second finding concerns what goes with better detection. Checks done by professionals with regular experience, checks that allowed more time, and checks that used a special dye to improve visibility were each associated with finding polyps. The authors say this is the first national evidence tying polyp detection to the experience of the person performing the test, the time allowed and the use of dye.

Dr Shahida Din, the study's principal investigator at the University of Edinburgh's Institute of Genetics and Cancer, set the problem against organized bowel cancer screening. IBD cancer checks are important, she said, but they do not have the same protected capacity. She noted that regular experience, more time and dye were associated with finding more polyps, and that further research should establish whether more consistent pathways and dedicated time improve detection of precancerous changes and, ultimately, patient outcomes.

The study has clear limits, which the team states itself. The database did not include laboratory results for polyps that were removed, so the work cannot say whether the differences in detection led to fewer cancers. Finding more polyps is not the same as preventing cancer, and which changes actually do that remains to be shown.

The work was a UK-wide collaboration, involving clinicians and researchers from NHS organizations and universities across all four nations. Experts say the results offer a starting point for measuring and improving IBD care, and support further investigation into whether consistent pathways and protected time lead to better outcomes. The next question is whether those changes reduce cancers, and that will need new research.