The good news: IBD treatment can minimize the risk.
When you think about treatment for inflammatory bowel disease (IBD), you probably think about wanting to reduce the number and severity of its symptoms, like diarrhea, bloody stool, and abdominal pain. These are all disruptive symptoms that can reduce your quality of life and make everyday tasks challenging.
However, treatment for the types of IBD—including Crohn’s disease and ulcerative colitis—also aims at healing the inflammation in the digestive tract. That’s because chronic inflammation over time can lead to additional health concerns—including colon cancer.
“People who have inflammatory bowel disease have chronic states of inflammation in the intestinal tract,” says Elliot Newman, MD, chief of surgical oncology at Lenox Hill Hospital, Northwell Health System. This can lead to dysplasia—when chronic inflammation causes normal cells to become abnormal, thus increasing the risk of cancer.
In the United States, colorectal cancer affects 4.5 percent of men and 4 percent of women, according to the American Cancer Society. However, people with Crohn’s disease or ulcerative colitis have a slightly higher risk, depending on how long they have had the disease and how severe or extensive the inflammation is.
How to Manage Your Risk of Colon Cancer
If you have Crohn’s disease or ulcerative colitis, you are not “doomed” to colon cancer. There are things you can do to lower your risk, as well as to catch colon cancer early.
For starters, someone with IBD should get colon cancer screenings earlier and more often than someone with average risk. For example, the Crohn’s and Colitis Foundation recommends that people who have had IBD symptoms for eight years or longer should have a colonoscopy every one to two years. (Find out what to expect at your first colonoscopy here.)
Additionally, good disease management can reduce your risk of colon cancer. Effective treatment for IBD involves taking your medications as prescribed (even when you’re feeling well), living a healthy lifestyle for IBD, and checking in with your gastroenterologist at least once a year. Here are other tips to lower your risk of colon cancer (whether you have IBD or not).
“There seems to be some evidence that people with inflammatory bowel disease who are treated and can keep the inflammatory cycles controlled … might have a lower risk of developing colon cancer,” says Dr. Newman.
Dr. Newman is the chief of surgical oncology at Lenox Hill Hospital, Northwell Health System, and a professor at Donald and Barbara Zucker School of Medicine at Hofstra/Northwell.
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Inflammatory bowel disease is a disease that affects the intestine
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and leads to chronic inflammation in the intestine.
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There are two common forms: one is known as Crohn's disease,
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which affects both the small intestine and the large intestine,
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or any place in the intestinal tract, for that matter,
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and one is called ulcerative colitis,
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which really affects only the large intestine and the rectum.
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People who have inflammatory bowel disease
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have chronic states of inflammation in the intestinal tract,
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and the chronic states of inflammation over time
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can lead to what's called dysplasia,
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meaning that normal cells are now abnormal, and with time,
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dysplasia can eventually lead to the development of cancer.
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The risk of developing colon cancer is, today, felt to be pretty similar
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between Crohn's disease and ulcerative colitis.
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And both situations mandate more intense screening
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of the colon and rectum, at earlier ages,
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and on a more frequent basis than for the average-risk patient.
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There seems to be some evidence that people
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with inflammatory bowel disease who are treated
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and can keep the inflammatory cycles controlled or less,
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might have a lower risk of developing colon cancer,
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but in general, people with inflammatory bowel disease
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have to be carefully watched by their doctors and screened very carefully
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to watch for the increased risk of developing colon and rectal cancer.
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Key statistics for colorectal cancer. Atlanta, GA: American Cancer Society. (Accessed on December 9, 2019 at https://www.cancer.org/cancer/colon-rectal-cancer/about/key-statistics.html.)
Patient education: Crohn’s disease (beyond the basics). Waltham, MA: UpToDate, 2019. (Accessed on December 9, 2019 at https://www.uptodate.com/contents/crohn-disease-beyond-the-basics.)
The risk of colorectal cancer in Crohn’s disease and ulcerative colitis patients. New York, NY: Crohn’s and Colitis Foundation. (Accessed on December 9, 2019 at https://www.crohnscolitisfoundation.org/what-is-ibd/colorectal-cancer.)