Research by Nigel D'Souza

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Mr Nigel D’Souza led the landmark NICE FIT study, a national multicentre trial that recruited over 10 000 patients. This study evaluated the diagnostic accuracy of the faecal immunochemical test (FIT) for colorectal cancer and other colorectal disease.. This research was directly cited in NICE’s DG56 guidance, which states the study “demonstrates the clinical and cost effectiveness of FIT in symptomatic patients,” and led to a change of national pracice.  Key publications include studies Gut , the British Journal of Surgery, and Colorectal Disease. He is well placed to advise on the interpretation and significance of FIT results in his private practice. 

Mr Nigel D’Souza has changed practice with his research to redefine the anatomical boundaries of the rectum. This has transformed how rectal cancer is diagnosed, staged, and surgically managed. His international Delphi consensus, published in nAnnals of Surgery, established a global definition of the rectum now influencing guidelines and multidisciplinary care. This was further supported by MRI-based studies validating anatomical landmarks, such as the sigmoid take-off, published in EJSO and Colorectal Disease, and analysis of the "rectosigmoid problem" in Surgical Oncology. The sigmoid take-off is now described in international and national guidelines from the Netherlands.

 Mr. Nigel D’Souza's research has significantly advanced the preoperative assessment of sigmoid colon cancer through the application of computed tomography (CT) imaging. He first described the TDV staging system in his study published in JAMA Network Open, which demonstrated that traditional TNM staging often fails to identify high-risk patients. Instead, the presence of extramural venous invasion and tumor deposits on CT scans were found to be more reliable indicators of disease recurrence, suggesting that these features could guide decisions regarding neoadjuvant therapy . This staging system was reproduced in further studies published in the Annals of Surgery,  and expanded in his EJSO study on patterns of recurrence, forming the foundation for the impending MERCURY 3 study.

Nigel D’Souza actively offers patients the opportunity to participate in cutting-edge clinical trials at UHS, providing access to innovative treatments and advancing colorectal cancer care. He is currently principal investigator for:

• BNT122 Colorectal Cancer Vaccine Trial — evaluating a novel vaccine aimed at stimulating the immune system to target colorectal cancer cells. More info
• ONCORE Database — a prospective registry collecting detailed clinical and molecular data to improve understanding and management of colorectal cancer. More info
• PRESERVE Study — investigating strategies to preserve organ function and quality of life in rectal cancer patients undergoing treatment. More info
• MERCURY 3 Study (in setup) — focusing on advanced imaging techniques to improve staging and tailor therapy in rectal and sigmoid colon cancer. More info

Patients recruited to these studies benefit from access to novel therapies and contribute to research shaping future colorectal cancer care.