Risk of ulcerative colitis and colorectal cancer: what you need to know

If you suffer from ulcerative colitis (UC), you probably know that inflammation is the cause of many of its symptoms. But what is less known is that it is also a likely cause of an increased risk of colorectal cancer.
Why ulcerative colitis is linked to increased risk of colorectal cancer
“The greater the inflammatory burden, and perhaps the longer a person with UC continues to have inflammation, the greater the risk of developing colorectal cancer,” says Edward L. Barnes, MD, a gastroenterologist and assistant professor of medicine at the University of North Carolina at Chapel Hill.
Additionally, if you are in the subgroup of people with UC who also develop primary sclerosing cholangitis — a rare disease that causes scarring in the bile ducts of the liver — your risk of colorectal cancer may be significantly higher.
What to do to prevent and detect colorectal cancer
You can take steps to reduce your risk of colorectal cancer.
1. Find a UC treatment that works
Newer UC medications allow some people to achieve remission, Dr. Barnes says. If your current treatment regimen fails to control your symptoms, talk to your doctor about exploring new options, he advises, both for “better symptom control and better quality of life.”
If your UC does not respond to medications, surgery is also an option. A procedure called proctocolectomy involves removing your entire colon and rectum to remove UC.
2. Once you find an effective treatment for UC, stick to it
“The main way we try to reduce the risk of colorectal cancer in UC patients is to better control inflammation,” he says. “We hope that better control of UC will reduce the risk of developing colorectal cancer. »
3. Eat a Nutritious Diet and Avoid Trigger Foods
You should also avoid any foods that seem to trigger your symptoms. Triggers often vary from person to person, but in general, it helps to avoid foods high in fat or refined and added sugars, as well as:
- Dairy products high in lactose
- Caffeine
- Alcohol
- Raw fruits and vegetables, which are harder on the intestine than cooked, chopped or pureed fruits and vegetables
- Spicy foods
4. Exercise regularly
Exercise can help manage many complications of UC, including reduced bone density, the mental health effects of living with UC, and a weakened immune system, which can hinder your body’s ability to prevent inflammation.
5. Get screened for cancer
Colorectal cancer may develop earlier in people with inflammatory bowel disease (IBD) than in people without it, says Amosy Ephreim M’Koma, MD, a colon and rectal surgeon at Vanderbilt-Ingram Cancer Center in Nashville.
This is primarily because the cumulative inflammation of the colon seen with EC likely accelerates the development of genetic mutations that cause cancer, says Dr. Ephreim M’Koma.
It’s called a “surveillance colonoscopy” and your doctor will “look for any early signs of dysplasia or precancerous changes,” Barnes says. “The presence of dysplasia will often trigger changes in how we manage the patient’s condition. Ensuring the patient undergoes colonoscopies to try to identify these changes early, before they develop colorectal cancer, is a key point of risk management.”
Takeaways
- Inflammation caused by ulcerative colitis can lead to cellular changes in the rectum and colon that increase the risk of colorectal cancer.
- Managing UC with medication, getting cancer screening every one to three years after diagnosis, avoiding trigger foods, eating a balanced diet, and exercising regularly can all help reduce inflammation and the risk of colorectal cancer.
- Work closely with your doctor to manage your UC and your cancer risk as much as possible.