Inflammatory Bowel Disease and Colorectal Cancer Risk: Understanding the Link

• More than three million people in the U.S. live with inflammatory bowel disease (IBD), a term for chronic inflammation of the gastrointestinal tract. Unfortunately, having one of the two most common inflammatory bowel diseases (Crohn’s disease or ulcerative colitis) can significantly increase one’s colorectal cancer risk.

  Both conditions involve increased inflammation in the colon, which can lead to the formation of abnormal cells in the colon lining or rectum that can become cancerous. Having very severe inflammation, IBD for more than eight years, a family history of colorectal cancer, or primary sclerosing cholangitis (an inflammatory bile duct condition that affects some people with IBD) can raise that risk even more.

  “Patients with IBD shouldn’t be scared, but they need to be aware of their cancer risk,” said Michael Bartel, MD, PhD, a gastroenterologist at Fox Chase Cancer Center.

  Screenings are Essential

  Early detection is key for successfully managing colorectal cancer, so it’s important to talk with your doctor about how often you should be screened. If you’ve had IBD for eight or more years, it is recommended that you undergo a colonoscopy every one to two years.

  IBD patients should also consider an advanced method of cancer screening called chromoendoscopy as part of their colonoscopy. The procedure, which involves spraying blue dye into the colon, tracks down flat, precancerous lesions that conventional colonoscopies can’t always detect.

  “Those flat lesions can be easily missed in anyone, but especially in people with IBD,” Bartel said. “Catching the lesions sooner, before they turn into cancer, makes them much easier to treat.”

  Other Protective Measures

  Taking steps to keep your IBD well managed can also go a long way. Seeing your gastroenterologist at least once a year, taking your medications regularly (even when you’re feeling well), and letting your doctor know of any new symptoms (or if someone in your family is diagnosed with colorectal cancer) is incredibly important. Making an effort to eat well, limiting red meat consumption, and exercising regularly is also advised.

  Staying aware of your cancer risk on top of dealing with IBD can feel overwhelming, but there’s reason to stay positive. Advancements in colonoscopy technologies are helping to catch more lesions sooner when they’re highly treatable, and thanks to increased screening and inflammation-reducing IBD drugs, fewer people with IBD are developing colorectal cancer today than in the past.

  Learn more about Fox Chase’s gastroenterology team and our services for IBD patients