The Risk of Colorectal Cancer in Crohn’s Disease and Ulcerative Colitis Patients

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.

Minimizing your Colorectal Cancer Risk

Video Length 3:00

Minimizing your Colorectal Cancer Risk IBD patients can minimize their colorectal cancer risk. Listen to learn more!

Transcript

after spending eight years with an

00:02

inflammatory bowel disease you learn to

00:04

live with it but then at that eight year

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mark another wrinkle gets thrown in

00:07

you're an increased risk of developing

00:09

colorectal cancer I can't say that I'm

00:13

not nervous about it that's Jonathan

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Miller a 28 year old salesman in Chicago

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he was diagnosed eight years ago so he's

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just entering that era of heightened

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risk whatever happens is gonna happen

00:23

when I get there I'm gonna deal with it

00:25

trying to eat right trying to work out

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it's all about keeping my IBD under

00:29

control if I'm experiencing something

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like the T nausea diarrhea I'm gonna

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talk to my doctor because that could be

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a normal flare-up or it could be

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something more he's got the right idea

00:39

because the formula for minimizing your

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colorectal cancer risk is first to

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control your IBD and then to make sure

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you and your doctor are vigilant about

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monitoring for cancer and that's a

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challenge when things are going well

00:50

here's dr. Jeannie Ashburn from the

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Cleveland Clinic it's very easy to look

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at that patient and say we're doing a

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great job at controlling their symptoms

00:58

and their flares but what goes

00:59

hand-in-hand with that is these patients

01:01

have an increased risk for developing a

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cancer down the road or even in the

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short term and we need to survey them

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and make sure we're staying on top of

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that the key risk factors of the

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duration and severity of the disease and

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also genetics it's important to stick to

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your meds control flare-ups and have

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regular checkups that focus on cancer

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surveillance as well as a colonoscopy

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every 1 to 2 years the benefit of doing

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this routinely is that we can pick up on

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surveillance abnormal cells that may

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alert us to either a precancerous lesion

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or a cancer itself diagnostic technology

01:37

is improving helping doctors catch

01:39

problems early last week for example

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doctors discovered a polyp on the colon

01:43

of missio Doherty a senior at the

01:45

University of Denver I ended up going to

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the hospital because I was just having

01:50

IBD symptoms it was so severe something

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I never felt before and there was the

01:55

polyp her doctors don't yet know if it's

01:57

precancerous but still it was unwelcome

02:00

news

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I had a breakdown and was pretty upset I

02:04

was falling and just saying why like

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this is not fair like why does this have

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to happen to me but the good news is

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that it was caught early and now Missy

02:11

and her doctor have time to make the

02:13

best choice I don't want to get to a

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point where we've waited too long and

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then we go in and see that it's really

02:18

severely I'd rather have my colon

02:20

removed and have really severe cancer

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Missy was back at the gym this morning

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working out and by afternoon was helping

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her sorority recruit new members she's

02:29

managing cancer risk just like her IBD

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with determination that discipline and

02:34

practicality I think it's only gonna

02:37

slow me down as much as I let it just

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like I'm Edie

02:41

[Music]

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[Music]

 

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

Thinking About Colorectal Cancer

Video Length 00:01:56

Thinking About 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 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.

 

This educational material is supported by the Maxine and Jack Zarrow Family Foundation. Additional support is provided through the Crohn's & Colitis Foundation's annual giving programs and donors.

 

A special thank you to the patients, caregivers, and medical professionals on our Patient and Professional Educational Advisory Committee for their contributions to this resource.