Q: Does having inflammatory bowel disease affect my risk for developing colon cancer?
A: Yes. If you go back 20 years, the thinking was that just ulcerative colitis was associated with increased risk of colon cancer. But we’ve found more recently that inflammatory bowel disease (the umbrella term for diseases that involve chronic inflammation of the digestive tract, including ulcerative colitis and Crohn’s disease) does have a higher risk than the general population.
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There are two things we think about here when it comes to risk. The first one is the length of time that someone has had IBD. The second is the degree to which the bowel is affected. So patients that have had it longer and have more of their colon affected are at a higher risk – and that’s for both patients with Crohn’s and ulcerative colitis.
In people without inflammatory bowel disease, the pathway to cancer is pretty clear-cut, where you get a polyp, the polyp becomes dysplastic, and then ultimately you get cancer. But the IBD pathway can be different. So not only is it important that we control these patients’ inflammation, but also that we follow up with them at more frequent intervals to make sure they don’t have cancer.
— Colorectal surgeon Scott Steele, MD