Approximately 2% of the population are endoscoped per year for both symptoms and screening for gastrointestinal cancers (GI cancers), and many patients will be offered repeated surveillance endoscopies. Endoscopy is invasive and expensive and a limited resource; however risk of GI cancer is not evenly distributed across the population. Therefore we aim to direct endoscopy to those at highest risk: “Precision endoscopy”. This would focus the powerful cancer preventative effect of limited endoscopy resources to maximum benefit and avoid endoscopy for those at low risk.
James and his team are researching ways to optimise endoscopy resources for GI cancer prevention. This ranges from risk stratifying patients using molecular techniques in high risk groups e.g. copy number alterations in colitis associated dysplasia (more information here), via testing advanced imaging techniques head-to head in clinical trial e.g. Chromoendoscopy versus Autofluorescence imaging (AFI) in colonoscopy (more information here), to considering broader questions through meta-analysis such as does endoscopic surveillance in patients with inflammatory bowel disease prevent colorectal cancer and death from colorectal cancer (more information here).