Supporting the

Neuroendocrine Cancer Community

Professor John Ramage – NCUK research grant awardee 2014

Mar 9, 2021

The project was to identify the number of Colorectal and Ileal NENs  found in the Bowel Cancer Screening Programme (BCSP). The aim was to understand how they were identified, how they were investigated and how they were treated.

The Bowel Cancer screening programme has screened > 1 million people using faecal occult blood (FOB -blood in the stool) testing and > 17,500 colonoscopies have been performed. Overall, 7.8% (women) and 11.6% (men) of the colonoscopies detected a colorectal (CR) cancer. However, the data regarding the number of NEN tumours identified had not been analysed.

The incidence of CR NEN in the general population is thought to be 1.3 per 100,000. The incidence in patients with positive FOB is unknown but CR cancer incidence is 46 per 100,000 in England and thus NEN incidence might be 46/1.3 times less likely to be found than CR cancer. This would be 35.4 times less likely which would equate to 1772/ 35.4 = 50 cases. It is also possible that some Ileal NENs will have been found during colonoscopy, and these are twice as common as CR NEN.

The study was to assess whether screening has any value for earlier diagnosis – and establish how many of the NENs identified were referred on to specialist Neuroendocrine Cancer care.

Ileo-colonic neuroendocrine tumours identified in the English bowel cancer screening programme (BCSP) Colorectal Disease (2018).

Professor John Ramage, is a consultant physician in gastroenterology and hepatology, honorary consultant physician at the Institute of Liver Studies, King’s College Hospital and former lead clinician for King’s Health Partners NET Centre which includes King’s, Guys and St Thomas’s, Kent Oncology Centre and Hampshire Hospitals. He is the deputy research director at Hampshire Hospitals Foundation Trust and lead clinician for the Hampshire Collaboration for Health Research and Education. He trained at Portsmouth, Brighton and King’s College hospitals.

Professor Ramage is an advisory board member, past treasurer and immediate past Chair of the U.K. and Ireland Neuroendocrine Tumour Society and also member of the EORTC Quality of Life Group, through which he pursues research into quality of life in cancers.

He is on the executive board of ENETs and chief investigator for several UK and international studies:  recently coordinating Hampshire Hospitals Foundation Trust input into the RECOVERY study for COVID-19. He has also taken part in the recent webinars on COVID-19 and NEN patients for ENETS and has co-authored the UKINETS statement on this topic.  

His main research interest is in quality of life and symptoms scores in neuroendocrine tumours of the small bowel and liver. 

He has written more than 150 peer-reviewed publications, and was the corresponding author of the UK guidelines for NENs. 

In my spare time I play keyboard for the hospital band and cycle the lanes of Hampshire.

  • Incidence of neuroendocrine neoplasms in England 2015–2017 Gut (2021)
  • International validation of the EORTC CAT Core: a new adaptive instrument for measuring core quality of life domains in cancer Quality of Life Research (2020)
  • Health-related quality of life in neuroendocrine neoplasia: A critical review Endocrine Related Cancer (2020)


Healthcare Science Week is an annual week-long programme designed to promote the amazing work of healthcare science professionals and highlight the difference they make to patients lives. This year, it takes place between 5 and 14 March.

Science and technology is vital in modern healthcare and can change lives for the better.

Research is one aspect where science and technology comes together not only to expand our knowledge but also explore new ways of delivering healthcare – whether through improved understanding of ‘the patient experience’ to new advances in knowledge to the development of innovative medicines and technologies.

To celebrate Healthcare Science Week we would like to share with you how your donations have made a number of complex and groundbreaking pilot research projects possible.

Find out more about our Research Grants and the work your donations help us support here.