The gold standard for colorectal cancer (CRC) diagnosis is colonoscopy. Although able to diagnose CRC, colonoscopy does not provide a cancer risk assessment among healthy-appearing individuals. Age is the number one risk factor for CRC, with diagnostic colonoscopy recommended in Cyprus over the age of 50 (45 in other countries) and every 5 years thereafter for everybody except those with a history of colorectal inflammation or cancer. Our objective is to develop a model that would only require samples taken during diagnostic colonoscopy to determine the probability of developing CRC in the following years, thus enabling more efficient timing of follow-up diagnostic colonoscopies. We expect this to both save lives for individuals at very high risk, who may benefit from more frequent diagnostic tests, while also reducing the cost of healthcare, and increasing the quality of life of people at very low risk of developing CRC.


The Infection and Cancer Laboratory led by Yiorgos Apidianakis at the University of Cyprus in collaboration with:

  • Gastroenterologists at the Nicosia General Hospital and private clinics
  • The microbiota-specializing company AVVA Pharmaceuticals Ltd
  • The advanced-analytics company Stremble Ventures Ltd

runs a clinical study towards the development of Molecular Colonoscopy, an affordable personalized risk assessment tool able to predict the relative risk for colorectal neoplasia among individuals currently defined as being at low risk via conventional colonoscopy.

By sampling normal-appearing colonic mucosa, faecal material and blood, we are assessing molecular signatures that may indicate risk. Lifestyle information is also assessed to eventually stratify healthy-appearing individuals into high and low risk groups.

Following the completion of the ongoing clinical study, a second prospective study is scheduled to validate and customize our diagnostic method as a service to gastroenterologists and the aging healthy appearing population.

The project is expected to establish Cyprus at the forefront of colorectal cancer prevention and contribute to the development of a risk assessment tool of major clinical and economical importance worldwide.


The ongoing project has received funding from the Research Promotion Foundation (RPF) and has been approved by the Cyprus National Bioethics Committee (Protocol numbers: EEBK/ΕΠ/2015/38 and EEBK/ΕΠ/2019/23).