Research & Publications

Across 12,064 colonoscopies, the individual doctor performing the procedure mattered more for detecting flat serrated polyps than the type of specialist training they had. Translation: who scopes you is more important than what badge they wear. This is why we publish our own detection rates openly and benchmark them against the best in the world.

We looked at what predicts whether serrated polyps are found at colonoscopy. The strongest predictors were a positive FOBT (faecal occult blood test — the kit posted to you by the National Bowel Cancer Screening Program) and well-measured quality indicators. If your FOBT comes back positive, do not delay the follow-up colonoscopy — that test is identifying people at significantly higher risk, including for the flat polyps that are easiest to miss.

Serrated polyposis syndrome (SPS) is an under-recognised condition where the bowel develops many serrated polyps, raising lifetime bowel cancer risk. We characterised who gets SPS and which features predict the polyps becoming pre-cancerous (developing "dysplasia"). For patients diagnosed with SPS, this work helps your specialist tailor how often you need surveillance colonoscopies — more closely if you carry higher-risk features, less intensively if you do not.

Receiving a diagnosis like SPS carries a psychological and economic cost that medicine often overlooks — health anxiety, lost work time, and fear of cancer. We measured how much. The point of the study is to make sure that clinicians acknowledge and address the worry that comes with a polyposis diagnosis, not just the medical surveillance. If you are struggling with this, raise it — we have resources and your concerns are evidence-based, not exaggerated.

Many older patients have diverticular pouches in their colon. When a polyp grows right next to one, surgeons have traditionally been the only option because of the perforation risk. This collaborative paper with Japanese centres showed ESD can safely remove these lesions through the scope in experienced hands — sparing patients an operation and the recovery that goes with it.

A gastric lesion thought to be benign on biopsy turned out to be a sarcoma (a rare cancer) once fully removed. The case demonstrates two things: fine-needle biopsy can miss the diagnosis in rare tumours, and endoscopic full-thickness resection is now an option for selected gastric lesions previously sent straight to surgery. For patients, this means we can sometimes deliver both a curative removal and a complete diagnosis in a single scope procedure.

A bladder cancer (urothelial carcinoma) presented as a thickened, rigid rectum — a pattern usually associated with stomach cancer, not bladder cancer. The report exists so that other doctors recognise this unusual pattern earlier and so that patients with hard-to-classify rectal disease get the right diagnosis sooner. Cases like this matter because they refine what we look for during routine endoscopy.