April 4, 2019

Here’s Why Inflammatory Bowel Diseases Like Crohn’s Disease And Ulcerative Colitis Increases Your Risk For Colon Cancer

Chronic inflammation leads to repetitive damage to the lining in your intestinal wall, making your colon more vulnerable to cancer

Inflammatory bowel disease

Living with an inflammatory bowel disease (IBD) means you’re faced with a new normal. Nutritional plans, lifestyle changes and being physically active on a regular basis can make a world of difference when you’re faced with flare-ups from Crohn’s disease or ulcerative colitis.

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But when these conditions go unnoticed, unmanaged or untreated for long periods of time, they can wreak havoc on your bowels and leave your intestines vulnerable to bigger problems like cancer.

Below, colorectal surgeon Scott R. Steele, MD, MBA, explains just how these chronic conditions are linked with colon cancer and what you can do to reduce your risk.

The link between ulcerative colitis, Crohn's disease and cancer

Doctors aren’t entirely sure what causes inflammatory bowel diseases like Crohn’s disease or ulcerative colitis. But we do know that they’re related to a dysfunctional immune response that occurs within your digestive tract.

When you have one of these chronic conditions, you can experience inflammation that builds up and spreads throughout your digestive tract — from your anus through your colon and all the way up to your stomach and your small intestine (for Crohn’s). With each flare-up, inflammation may worsen over time so that it causes damage to the lining of your intestinal walls, leaving them swollen, irritated, damaged and often covered in lesions or scar tissue. In the attempt for the lining of your intestinal wall to heal itself from these attacks, your cells try to recover and regrow. But this can lead to an over-abundance of cell growth resulting in polyps, precancerous growth and colorectal (colon) cancer.

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“Anything associated with chronic inflammation is a risk factor for the development of colorectal cancer because chronic inflammation leads to a higher turnover of the lining of the cells in the colon, which may ultimately lead to the development of colorectal cancer,” explains Dr. Steele.

Of those with IBD, who is most at risk?

Some studies have found that people who have IBD are six times more likely to develop colorectal cancer than the general population. Recent studies have shown that IBD-related colorectal cancers have declined in recent decades due to improved cancer screenings and improved inflammation management. But several of the following factors have been identified to increase your risk for colon cancer if you’re living with IBD:

“Certain disease processes go together and ulcerative colitis and PSC in some patients are connected,” adds Dr. Steele. “When you have PSC, you tend to have more potent or worse colon inflammation and symptoms, which leads to a slightly higher risk of having colon cancer.”

Why colon cancer screening is important

“People who have been diagnosed with ulcerative colitis and Crohn’s disease should be getting exams regularly just to monitor their underlying disease, so they’re probably getting evaluated for colon cancer to begin with,” says Dr. Steele. “Certainly, if they have biopsies that show dysplasia, or abnormal tissues, we will follow those patients more often up to and including annually or every other year, depending on what the biopsies show.”

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That means even if your IBD is in remission, you should still get screened for colon cancer on a regular basis, especially if you haven’t been examined in the last five to 10 years. These screenings can help doctors catch colon cancer even in its precancerous and earliest stages of growth — and, during examination, they can remove these areas of concern in real-time.

“The unique thing about endoscopies is that they can detect tumors when someone is asymptomatic and they’re just at their infancy, at the dysplasia or small polyp stage,” says Dr. Steele. “Other cancers, like pancreatic cancer, are oftentimes diagnosed at a later stage. But an endoscopy has the ability to detect polyps, early-stage lesions and multiple polyps throughout the colon, or to even give people a peace-of-mind that they don’t have anything growing in their colon.”

How to reduce your cancer risk

If you’re living with IBD, reducing your risk for cancer is directly tied to reducing IBD flare-ups. By focusing on healthy habits and lifestyle changes, you can lower your risk for cancer by trying the following:

“Certainly, the development of cancer has multiple factors linked to it,” explains Dr. Steele. “But it’s important that a healthy lifestyle includes regular screening examinations, and open communication with your healthcare provider is critical. Endoscopy has a role in colon screening and can even save your life.”

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