Research question
Are younger, overweight patients who take metformin, less likely to develop bowel cancer and bowel polyps than other patients who don’t take metformin?
Background
Bowel cancer is common and affects 42 000 people per year in the UK. Sadly only 57% of people survive more than 10 years after diagnosis. It is thought that up to 54% may be prevented by improving lifestyles; avoiding obesity, red/processed meat, smoking and alcohol and increasing daily exercise.
Wider research has shown worryingly information that younger patients are at higher risk of developing bowel cancer.1 in 4 will present to their doctor with advanced disease that is difficult to treat. Research is urgently needed to counteract this increasing burden in younger patients. Routine screening in only offered to patients generally 60 years and above. In this age group, however, the burden of bowel cancer seems to be stable.
Metfomin is a commonly used drug treatment taken by patients diagnosed with type II diabetes. Interesting early research has shown that it may also be beneficial in reducing the risk of developing some cancers including bowel cancer.
In order to address this research gap our team has developed a clinical and translational collaboration to investigate the effects of metformin, insulin and glucose on patients with bowel cancer. We have 1 combined PhD student and have successfully set up a colorectal tumour collection with over 100 samples. Currently there is no evidence available for metformin use in younger obese people at increased risk of bowel cancer.
Design
We will undertake observational research into people under 55 years with a diagnosis of bowel cancer or bowel polyps that are known to lead to bowel cancer. We will look specifically at their weight, family history and if they are taking metformin medication. We will obtain this information locally at North Bristol Trust and in addition will ask permission to access the UK Biobank to look at UK based data.
Future
This work will form the basis of a collaborative North Bristol and University of Bristol research programme over 5 years that will investigate the role for metformin in preventing bowel cancer in overweight younger patients. With the help of this grant we intend to provide robust data on which to develop our research programme. After completing this work, the next step for us will be developing our patient focus group who will help us in working out what is important for younger patients who wish to avoid the risk of developing bowel cancer.