Patients with ulcerative colitis and Crohn’s disease involving the colon need to be especially vigilant about screenings for colorectal cancer. These patients are at higher risk for developing colorectal cancer than the general population.

Inflammation of the colon can cause continuous turnover of cells in the intestinal lining, which increases the chance of irregularities that may lead to cancer. Though the vast majority of patients with Crohn’s disease and ulcerative colitis will never develop colorectal cancer, it is important to discuss the risk with your doctor. Colorectal cancer is a highly treatable disease when it’s found early.

Colorectal Cancer Risk Factors

• A diagnosis of ulcerative colitis or a type of Crohn’s disease that only affects the colon, called Crohn’s colitis

• Eight to 10-year history of Crohn's disease or ulcerative colitis

• Severe and/or extensive colon inflammation

• Primary sclerosing cholangitis, a rare condition that causes bile duct inflammation and scarring

• Dysplasia, or changes in cells that are precursors of cancer, of the colon or rectum

• Family history of colorectal cancer

Early Detection is Key

Screening for colorectal cancer should be a regular and ongoing conversation between you and your doctors. There are things you can do to reduce your risk of developing colorectal cancer.

Screening Recommendations

• Patients who have had symptoms for eight years or longer should get a colonoscopy every one to two years.

• Regular colonoscopies can find precancerous tissue and early cancers, making it easier to treat.

• Work with your healthcare team to get your Crohn’s disease or ulcerative colitis inflammation under control. This will make finding colorectal cancer easier.

• Make sure to follow all instructions from your doctor on preparing your bowel before a colonoscopy.

Reduce Your Risk

• See your gastroenterologist at least once a year

• Keep a list of symptoms or concerns, and discuss these with your doctor at clinic visits

• Take your prescribed medications to keep your colon inflammation well-controlled

• Continue your medications, even when you are feeling healthy

• Notify your doctor if a family member develops colorectal cancer

• Exercise regularly and eat a healthy diet

Advances in Cancer Screening

There have been several advances in technology that can be used during a colonoscopy to improve the quality of surveillance and help identify cancer or precancerous lesions in the colon.

These tools include high-definition colonoscopy, scopes, processors, and screens, which can help increase the resolution of the images your doctor takes during a colonoscopy.

A chromoendoscopy may be done to help your doctor find polyps or precancerous changes during a colonoscopy. During a chromoendoscopy, a blue liquid dye is sprayed into the colon to highlight and detect slight changes in the lining of your intestine. You may have blue bowel movements after this procedure.

To read more about colorectal cancer screening and chromoendoscopy, visit the American Society for Gastrointestinal Endoscopy.