Prioritising the Colonoscopy Backlog for Earlier Cancer Detection

Status Completed
Timeline Feb 2023 –
Jun 2024
Partners Swansea Bay University Health Board CanSense Ltd

Project Lead(s)

Prof Dean Harris

Prof Dean Harris

Consultant Colorectal Surgeon, Swansea Bay University Health Board

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Fiona Hughes

Fiona Hughes

Associate Service Group Director, Integrated Medicine, Swansea Bay UHB

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This work explored the use of the CanSense blood test as a potential way to help stratify surveillance colonoscopy waiting lists by identifying patients at higher risk of having polyps or cancer.

With colonoscopy services under significant pressure, approaches that support more targeted use of invasive procedures could help services prioritise patients more effectively, reduce unnecessary appointments where clinically appropriate, and improve patient experience.

Just over 200 patients from Swansea Bay University Health Board, who were among the longest-waiting for their surveillance colonoscopy, were offered both a CanSense blood test and a colonoscopy. The results of the blood test were then compared with colonoscopy findings to understand the level of concordance. Patients were also asked to complete short feedback questionnaires at different points in the process, helping to assess the acceptability of a blood test as a potential triage tool.

Through the work, 116 patients were discharged from surveillance, 87 were advised that they would continue to require follow-up, and nine were referred for treatment, including two patients whose cancers were detected.

The work contributed to understanding how minimally invasive tests, such as CanSense, could support more targeted use of colonoscopy in the future. While further evaluation would be needed before wider adoption, the findings provide useful insight into how blood-based risk stratification could help services focus capacity on patients most likely to need investigation or treatment, while reducing unnecessary procedures for others.

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