How Ulcerative Colitis Affects Your Colon Cancer Risk

Ulcerative colitis (UC) is a type of inflammatory bowel disease that causes ulcers to form in the lining of your colon and rectum.

Research shows a link between UC and colorectal cancer.

The Link

People with UC are six times more likely to get some form of colorectal cancer. The main reason for this is inflammation.

Chronic inflammation raises your chances of colorectal cancer in three ways:

  • In your bowels, inflammation damages the genetic material in your colon cells. This can create mutations in those cells that could be cancer.
  • It raises your levels of certain molecules that can help cancerous tumors grow.
  • It makes viral and bacterial infections more likely. Those can interfere with your body’s immune system and encourage cancer cells to grow and multiply.

Who Gets Colorectal Cancer With UC

If you have UC, there are some things that raise your chances of getting colorectal cancer. They include if:

  • You've had UC for longer than 8 years.
  • You have a family history of colorectal cancer.
  • UC affects all or most of your colon.
  • The inflammation in your colon is severe or widespread.
  • Your UC leads to conditions like primary sclerosing cholangitis or dysplasia.

Signs of Colorectal Cancer

People with ulcerative colitis may not know they have colorectal cancer because signs of the cancer can be similar to their UC symptoms. It's helpful to know what red flags to look out for.

Common symptoms of colorectal cancer include:

  • Weakness or fatigue
  • Weight loss you can’t account for
  • Bleeding from your rectum, or blood in your poop
  • Feeling like your bowel isn’t emptying completely
  • Lasting discomfort in your belly and gut, like cramps, gas or pain
  • Ongoing changes in your bowel habits like diarrhea or constipation, or a change in the color or texture of your poop

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When to See Your Doctor

The earlier your doctor can diagnose colorectal cancer, the easier it is for them to treat. If your UC is severe or if you've had it for a long time, you should visit your doctor more often for tests.

A colonoscopy is a common test. It can find suspicious tissue and cells before they become cancer. Most experts suggest scheduling a colonoscopy once every 1-2 years if you’ve been living with UC symptoms for 8 years or more.

Also be sure to work with your doctor to manage your inflammation. That will make it easier for them to detect early signs of cancer.

Genetics can play a part, too. So tell your medical team right away if one of your family members finds out that they have colorectal cancer.

How to Avoid Colorectal Cancer

In addition to regular screening tests, a few lifestyle changes might lower your chances of colorectal cancer. You should try to:

Your doctor may prescribe medication to help lower your risk of colorectal cancer. One class of medicines, known as aminosalicylates, controls inflammation in your colon. So it’s important to continue taking your prescriptions, even when you're not dealing with many symptoms.

Be sure to stay on top of your health, as well. For example:

  • Make a yearly appointment to see your gastroenterologist.
  • Keep a list of all of your symptoms and concerns to take with you to your doctor visits.
WebMD Medical Reference Reviewed by Neha Pathak, MD on February 16, 2021

Sources

SOURCES:

NHS: “Complications: Ulcerative colitis.”

Mayo Clinic: “Colon Cancer,” “Ulcerative colitis.”

Crohn's & Colitis Foundation: “The Risk of Colorectal Cancer in Crohn’s Disease and Ulcerative Colitis Patients.”

Grivennikov, S., et al. Cell: “Immunity, Inflammation, and Cancer.”

Hnatyszyn, A. et al., Hereditary Cancer in Clinical Practice: “Colorectal carcinoma in the course of inflammatory bowel diseases.”

Itzkowitz, S. et al., “American Journal of Physiology-Gastrointestinal and Liver Physiology: “Inflammation and Cancer IV. Colorectal cancer in inflammatory bowel disease: the role of inflammation.”

Mattar, M., et al.: Gastrointestinal Cancer: Research & Therapy: “Current Management of Inflammatory Bowel Disease and Colorectal Cancer.”

Langan, R. et al., American Family Physician: “Ulcerative Colitis: Diagnosis and Treatment.”

Eaden, J. et al., British Society of Gastroenterology: “The risk of colorectal cancer in ulcerative colitis: a meta-analysis.”

Zhao, L.N., et al., PLOS: “5-Aminosalicylates Reduce the Risk of Colorectal Neoplasia in Patients with Ulcerative Colitis: An Updated Meta-Analysis.”

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