Research into bowel (colorectal) cancer

Researchers around the world are looking at preventing, diagnosing and treating of bowel cancer.

Bowel cancer means cancer that starts in the large bowel (colon) and the back passage (rectum).

Go to Cancer Research UK’s clinical trials database if you are looking for a trial for bowel cancer in the UK. You need to talk to your specialist if there are any trials that you think you might be able to take part in.

When in the trials database, click on ‘recruiting’, ‘closed’ and ‘results’ in the trial status tab to see all the trials.

Research and clinical trials

All cancer treatments must be fully researched before they can be used for everyone. This is so we can be sure that:

• they work

• they work better than the treatments already available

• they are safe

To make sure the research is accurate, each trial has certain entry conditions for who can take part. These are different for each trial.

Hospitals do not take part in every clinical trial. Some trials are only done in a small number of hospitals, or in one area of the country. You may need to travel quite far if you take part in these trials. 

Some of the research on this page has now stopped asking people to take part. But it takes time before the results are available. This is because the research teams follow the people taking part for a period of time to collect and analyse the information.

We have included information about these to give examples of the types of research being carried out.

Research into causes of bowel cancer

Gene changes in younger people

Researchers are looking at the genes of people under 40 with bowel cancer and comparing them with their parent’s genes. This is to see if this can help identify which changes cause bowel cancer.

Family history and genes

The risk of developing bowel cancer is higher in people with a family history of bowel cancer. This can be caused by an inherited gene change. The risk increases depending on which gene is damaged or which part of the gene is damaged.

Research teams are:

• looking at blood and tissue samples from people who have had bowel cancer and people who haven't had cancer

• collecting information about family history

• looking to see if genetic testing at home is possible, rather than in hospital

Research into preventing bowel cancer

Previous research shows that aspirin might lower the risk of getting some cancers. It may also prevent some cancers from spreading, or people dying from it. But we need more research to be sure.

Researchers are looking at aspirin:

• for people with Lynch syndrome to find the best dose to prevent cancer without too many side effects
• to see if it reduces the risk of cancer for people with primary sclerosing cholangitis or inflammatory bowel disease
• together with a diabetes drug called metformin to see if it prevents bowel polyps
• to see if it can stop cancer coming back after treatment

Research into tests to diagnose and monitor bowel cancer

Bowel cancer screening test

FIT (Faecal Immunochemical Test) is a test that looks for blood in a sample of your poo. It’s used as a screening test for bowel cancer in the UK. Researchers are looking into developing a test using different substances in the blood to screen for:

• bowel cancer

• large bowel polyps

The researchers think this may be a better and quicker way to screen for bowel cancer.

Tests to diagnose bowel cancer

Scientists are looking at newer tests to try and help improve the diagnosis of bowel cancer. These include:

• a breath test
• a rectal mucus test

Researchers are looking at using artificial intelligence (AI) to help diagnose bowel polyps more accurately.

Tests to help plan treatment

Researchers are looking at circulating tumour DNA (ctDNA). ctDNA are small pieces of DNA found in the bloodstream when cancer cells die. They take a sample of blood to look for ctDNA and to find specific changes (mutations ) in the DNA.

Finding these changes may help to plan treatment. Also to see how well treatment is working or see if a cancer has come back. 

Researchers are also looking at biomarkers . Research teams want to:

• find out if high levels of the biomarkers AREG and EREG can predict who will benefit from certain targeted drugs
• look for other biomarkers to help plan treatment
• look for biomarkers in people with increased risk of bowel cancer, to try and diagnose cancer earlier

Tests to look for small amounts of cancer left after treatment

Minimal residual disease (MRD) is the term for small amounts of cancer cells that are left after treatment. To find out about MRD specialists in a laboratory look at a sample of cells. They use very sensitive tests.

MRD is not a routine test in bowel cancer. Researchers are looking at testing MRD to see if they are able to spot cancer coming back after surgery earlier.

Using tests to avoid treatment (watch and wait)

Rectal cancer surgery has possible side effects. So doctors want to know if some people with rectal cancer can avoid having surgery after radiotherapy.

Researchers are looking at viewing MRI scans in a different way to see if it is possible to check how well radiotherapy has worked. This technique is called the mrTRG (MRI Tumour Regression Grade). Doctors use the mrTRG to decide whether you can have regular check ups and tests after radiotherapy, rather than surgery. Doctors call this watch and wait.

Research into bowel cancer treatment

Researchers want to:

• improve the current treatments we have
• develop new treatments

Research into surgery for bowel cancer

Researchers are looking at improving surgery for bowel cancer.

A serious possible side effect of rectal cancer surgery is a leak from where 2 bits of bowel have been joined. This is called an anastomotic leak.

A research study wants to see if a new technology can help reduce this. They want to use a technology called intraoperative fluorescence angiography (IFA) during the operation. This is a dye which is injected into the blood and makes it glow. It shows the surgeons the blood supply around the join which can help them make decisions during the operation.

Research into radiotherapy for rectal cancer

Radiotherapy means the use of radiation, usually x-rays, to treat cancer cells.

Researchers want to find out if they can safely increase the dose of radiotherapy for rectal cancer while making sure the side effects are not too bad. The aim is to try and prevent a large operation for some people.

A trial team are looking at how specific radiotherapy machines are used with the hope to improve them in the future.

Research into chemotherapy for bowel cancer

Chemotherapy uses anti cancer drugs to destroy cancer cells. 

Doctors sometimes use chemotherapy to treat bowel cancer. They are looking at ways to improve how well chemotherapy works. This includes using chemotherapy and other drugs before surgery. Doctors call this neoadjuvant treatment. Research includes:

• looking at chemotherapy before surgery for older people
• comparing different combinations of chemotherapy before and after surgery
• comparing targeted cancer drugs and chemotherapy before surgery
• using immunotherapy or other drugs before surgery instead of chemotherapy for older people, or those with serious medical problems
• giving chemotherapy in different ways
• improving ways to check how well treatment has worked before surgery

Research into targeted and immunotherapy drugs for bowel cancer

Targeted cancer drugs change the way cells work. They can block the signals that tell cells to grow. Immunotherapies can boost the body’s immune system to fight off or kill cancer cells.

Researchers are looking at giving these drugs on their own or with chemotherapy. So far this is mainly for bowel cancer that has spread or can’t be removed with surgery.

Research teams are also looking at different immunotherapy and targeted drugs before surgery (neoadjuvant treatment).

There are many types of targeted drugs and immunotherapies being researched in bowel cancer. We haven't listed them all here. Some examples are:

• drugs that block cancer blood vessel growth (anti angiogenesis treatment), such as aflibercept

• monoclonal antibodies, such as panitumumab, cetuximab and amivantamab

• immunotherapies, such as pembrolizumab, durvalumab, atezolizumab and dostarlimab

• dugs that target the KRAS, BRAF or MEK gene change such as sotorasib, vemurafenib and cobimetinib

• tyrosine kinase inhibitors, such as tucatinib

• a new virus treatment for rectal cancer called enadenotucirev (EnAd)

• a drug that is made up of 2 parts called datopotamab deruxtecan. It's made up of a monoclonal antibody called datopotamab. Deruxtecan is a chemotherapy drug

Cancer vaccines to treat bowel cancer

Vaccines are a type of immunotherapy. Cancer vaccines work by being made to recognise proteins that are on cancer cells. Researchers are looking at giving a cancer vaccine before surgery for people with microsatellite instability (MSI) high bowel cancer.

Researchers are looking at using personalised cancer vaccines. This means the vaccines are tailored to each person taking part. And their specific cancer.

The aim is to stimulate the immune system  to prevent cancer from coming back after surgery.

Research into exercise and living with bowel cancer

We know that eating a high fibre diet, less red meat and processed meat can reduce the risk of bowel cancer. There is also strong evidence that a healthy weight and exercising lowers the risk of bowel cancer.

A 2025 study showed that structured exercise can improve the chances of surviving colon cancer. People survived their cancer for longer if they:

• were supported in an exercise programme over 3 years
• started the programme soon after having adjuvant chemotherapy

Researchers are looking at other exercise programmes during treatment and how they help people with bowel cancer.