Ulcerative colitis (UC) can increase your colorectal cancer risk, but recent research suggests colorectal cancer rates are dropping among people with inflammatory bowel disease (IBD), such as UC. Regular screenings are recommended.
UC causes inflammation in your large intestine, including your colon.
The most obvious effects of the disease are symptoms such as diarrhea and abdominal pain. UC increases the risk of developing colon cancer, which is also known as colorectal cancer.
Read on to find out how UC contributes to colorectal cancer risk and what you can do to protect yourself.
UC causes inflammation that can eventually turn cells in the lining of your colon into cancerous cells. Colorectal cancer is the third most common cancer in both men and women in the United States (with the exception of skin cancers).
According to the American Cancer Society (ACS), the overall risk of getting colorectal cancer is
However,
Your risk for colon cancer typically starts to increase once you’ve had UC for 8 years, according to the Crohn’s & Colitis Foundation. The longer you have UC, the higher your cancer risk.
The authors of a
They also found that colorectal cancer rates in Asia increased dramatically after a UC duration of 10–20 years. Cancer rates for Asian people who had had UC for 10–20 years were four times higher than rates for Asian people who had lived with UC for 1–9 years.
Cancer rates for Europeans also increased as UC duration increased, but the increase in cancer rates over time wasn’t considered statistically significant. And there wasn’t enough data from Oceania to compare cancer rates over time.
This review had some noteworthy limitations. For instance, the authors did not include data for people who had experienced colorectal polyps (abnormal tissue growths) or a colectomy for UC, people with cancer outside of the colon or rectum, or people with a family history of colorectal cancer.
Inflammation
Your risk of getting colorectal cancer also varies depending on how much of your colon is affected by inflammation. If you have severe inflammation from UC, you may be at a greater risk of developing colon cancer.
People who have a lot of inflammation in their entire colon have the highest risk for colorectal cancer. Those with inflammation only in their rectum have the lowest risk.
Primary sclerosing cholangitis (PSC)
PSC is a rare complication of UC that affects your bile ducts, which carry digestive fluid from your liver to your intestine.
PSC causes inflammation and scarring that narrows the ducts. It also increases the risk of colorectal cancer, and the disease may start sooner than 8–10 years after you receive a diagnosis of UC.
Because your risk for colorectal cancer increases over time if you have UC, it’s important to have regular screenings for colorectal cancer.
A 2017 research review found that, for people with IBD who underwent regular screenings, the odds of developing colorectal cancer dropped by 42% and the odds of dying from the cancer dropped by 64%.
If you have UC, you should talk with your doctor about getting a colonoscopy, the main test used to detect this type of cancer.
There are other ways to screen for colon cancer as well. Your doctor can advise you on the best course of action.
Colonoscopy
Typically, people have their first colonoscopy at age 50, but if you have UC, you’ll likely start earlier.
During a colonoscopy, a healthcare professional uses a long, flexible tube with a camera at the end to see inside your colon. The test helps them detect polyps in your colon lining. The doctor can remove these growths to prevent them from turning into cancer.
Your doctor might also remove tissue samples during your colonoscopy and have them tested for cancer. This procedure is called a biopsy.
Getting regular colonoscopies can help lower your risk of developing colorectal cancer or dying from it.
Sigmoidoscopy
A sigmoidoscopy is similar to a colonoscopy but slightly less invasive. During the test, a healthcare professional will examine your rectum and your sigmoid colon using a flexible lighted tube and a tool that can remove polyps immediately.
Unlike a colonoscopy, this test does not usually require sedation since it involves looking at only the lower part of your colon.
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Stool tests
Stool tests are the least invasive because they can be done at home. A stool test checks for tiny amounts of blood in stool that are not visible. The test can also check for blood and abnormal DNA that could indicate cancer.
An abnormal stool test result does not mean you have cancer. But it does mean that it’s time to schedule a colonoscopy to determine the cause of any abnormalities. However, stool-based tests are generally used for people who have an average risk of developing colorectal cancer. If you have UC, you should talk with your doctor about an in-office screening.
How often to screen
Ask your doctor about starting to get regular colonoscopies if
Healthcare professionals generally recommend getting a colonoscopy every 1–3 years if you have UC. But you may need to have this test more or less often based on factors such as:
- your age at diagnosis
- how much inflammation you have and how much of your colon it affects
- whether you have a family history of colorectal cancer
- whether you also have PSC
Here are a few other things you can do to lower your chances of developing colorectal cancer:
- Ask your doctor about medications such as sulfasalazine (Azulfidine), vedolizumab (Entyvio), and mesalamine (Asacol HD, Pentasa), which may help lower your risk.
- Take your medications as your doctor prescribed them to keep your UC inflammation well managed.
- See your gastroenterologist for checkups at least once a year.
- Eat more fruits, vegetables, and whole grains.
- Limit your consumption of red meat (such as burgers, steaks, and pork) and processed meats (such as hot dogs, bacon, and sausage), as these may be linked to colorectal cancer.
- Avoid alcohol consumption or limit yourself to no more than one alcoholic drink per day.
- Get some physical activity most days, even if it’s just walking.
In addition to getting regular screenings, let your doctor know right away if you experience these symptoms of colorectal cancer:
- a change in your bowel movements
- blood in your stool
- stools that are thinner than usual
- excess gas
- a feeling of bloating or fullness
- diarrhea or constipation
- unexplained weight loss
- more fatigue than usual
- vomiting
If you have UC, your risk of developing colorectal cancer is higher than in people who do not have UC. It’s important to manage your UC with medications and get regular screenings for colon cancer. Also, make sure your doctor knows about any history of colorectal cancer in your family.
There are a few things you can do to reduce the risk, such as exercising regularly, eating a nutritious diet with little or no red meat or highly processed foods, and limiting or abstaining from alcohol.