People who have severe ulcerative colitis are at increased risk of developing colorectal (colon) cancer. But having a higher risk doesn’t mean you will absolutely get colorectal cancer. Only about 5 percent of people with severe ulcerative colitis end up with colorectal cancer. Plus, there are steps you can take to reduce your risk.
Ulcerative Colitis: Colorectal Cancer Risk Factors
Ulcerative colitis is a disease in which the colon becomes inflamed. Nobody is quite sure how it starts, but it's believed that people with ulcerative colitis have problems with their immune system that likely contribute to its development. In addition, this chronic disease often runs in families, as does colorectal cancer. Nearly 20 percent of people with colorectal cancer have a family member affected by the disease.
About 500,000 people in the United States have ulcerative colitis, while approximately 108,000 people are diagnosed with colorectal cancer every year.
The following factors increase the odds that you’ll develop colorectal cancer if you have severe ulcerative colitis:
- The more damage the inflammation of severe ulcerative colitis inflicts, the higher your risk of developing colorectal cancer becomes. In addition, sustained inflammation of the colon over time makes you more vulnerable to colorectal cancer.
- If only your lower colon and rectum are affected by ulcerative colitis, your chances of getting colorectal cancer are similar to the risks of people without ulcerative colitis; however, your risk can rise to 32 times that if your entire colon is affected. Those who get colorectal cancer usually have more of their colon affected by the ulcerative colitis.
Ulcerative Colitis: Tests for Detecting Colorectal Cancer
If you have risk factors for colorectal cancer, your doctor may order several tests to see if colorectal cancer has developed. They include:
- Fecal occult blood test (hemoccult): This is a simple test you can do at home that detects whether blood is present in your stool. However, since people with ulcerative colitis often have blood in the stool because of inflammation — not cancer — hemoccult testing is used in conjunction with other tests to properly diagnose colorectal cancer.
- Colonoscopy: This is a more thorough way to check for colorectal cancer in people with ulcerative colitis. During a colonoscopy, a thin, flexible tube with an attached camera is inserted up through the rectum. Your doctor is then able to visually examine your colon for any inflammation and signs of cancer, take a biopsy, or a sample of colon tissue, and remove any suspicious lesions, if necessary.
- Sigmoidoscopy: During a sigmoidoscopy the doctor uses the same methods used in colonoscopy, but only the lower part of the colon is examined.
People who have had ulcerative colitis for 8 to 10 years should have a colonoscopy yearly, or every other year, depending on the intensity of symptoms. Your doctor can advise you as to how often you should be screened for colon cancer given your individual condition.
Ulcerative Colitis: Lowering Your Risk of Colorectal Cancer
While you can't do anything about your genes, you can take precautions to prevent colorectal cancer. Here are some tips that may help reduce your risk of colorectal cancer.
Make sure you:
- See your doctor regularly: You should be checked out by your gastroenterologist annually, even if you have no worrisome symptoms. It's vital that the inflammation in your colon is monitored so that you're aware of what's going on inside you.
- Undergo regular colon cancer screening: An annual colonoscopy can insure early detection and treatment of colon cancer, should it end up affecting you. The sooner cancer is detected and treated, the better the outcome.
- Eat a healthy, antioxidant-rich diet, which may help to prevent cancer.
- Exercise often, which helps to move waste out of your body and can reduce your risk for colorectal cancer.
Ulcerative Colitis and Colon Cancer: Other Treatments
Some studies have found that statin drugs, typically used to lower cholesterol, may also lower a person's risk for colorectal cancer. However, the jury is still out as to whether statins actually lower the risk of colorectal cancer in people with ulcerative colitis.
Research has also shown benefits from an inflammation-reducing drug called infliximab (Remicade), commonly prescribed for people with rheumatoid arthritis and recently approved as an ulcerative colitis treatment, in reducing colon cancer risk. In one trial, participants required fewer surgeries on their colons while taking infliximab. Those whose disease was less severe had even fewer surgeries. However, it is still not clear whether infliximab can lower the risk of colorectal cancer in people with severe ulcerative colitis.
If you have severe ulcerative colitis, you should continue getting regular checkups, even if you feel well. Balance the danger of a future with colon cancer against the minor inconvenience of regular colon cancer screenings, at whatever intervals your doctor recommends. Chances are you will not get colon cancer. But if you do, catching it early can make all the difference.
Last Updated: 3/27/2013