A new device for the detection of colorectal cancer in IBD

What is this research looking at? 

Bowel cancer is the second most common cause of cancer death in the UK. People with Inflammatory Bowel Disease (IBD) have a bowel cancer risk 2-3 times higher than normal, often occurring at a much younger age. Cancer and IBD symptoms are similar, so cancer diagnosis may be delayed. Many national societies recommend that patients with colonic IBD have regular surveillance for colorectal cancer. Patients with IBD fear having cancer and it has a significant burden on healthcare resources. 

It has been shown that chromoendoscopy (CE), where a blue coloured dye is sprayed on the bowel mucosa while withdrawing the endoscope, is the most effective method to check for cancer in IBD patients. However, it is not often used in clinical practice due to several factors: 

• Even dye spraying is difficult to achieve with current spraying systems 
• When using a spray catheter a lot of time is spent exchanging the spray catheter and the biopsy forceps when suspicious lesions are found 
• CE is time consuming and increases the procedure time from between 9 to 26 minutes 

Working in collaboration with the Medical Engineering group at the University of Leeds, the researchers have measured characteristics of the sprays used in CE (e.g. droplet sizes, coverage). They found that by adapting the spray device with a simple improvement in nozzle design and using a spring-loaded multi-spray syringe, droplet dispersion and coverage can easily improve. The researchers would like to extend this work to develop and test a prototype device that is integrated into a biopsy forceps with a spring-loaded multi-spray syringe, coupled with a better spray nozzle for improved and easily obtained mucosal coverage with the dye. It will also reduce the time needed to obtain samples. 

What do researchers think this could mean for people with IBD?  

The researchers hope that this novel spray device will improve the accuracy and efficacy of chromo-endoscopy, and reduce the time taken to carry out the procedure. Ultimately, they hope it will lead to better detection rates of colorectal cancer and improved outcomes for patients. 

Who is leading this research: Dr. Venkat Subramanian, University of Leeds Our Funding: £58,067 
Duration: 12 months 
Grant reference: M2017-5 
Official title of application: Endo-spray: A device to improve chromoendoscopic surveillance for IBD to reduce the time taken and improve the utilization and uptake of this NICE and BSG recommended technique in routine NHS practice. 
Tags: Bowel cancer and IBD