The bad news is that people who have Inflammatory Bowel Disease are at higher risk for developing colon cancer. The good news is that colon cancer is highly treatable when caught early.

Colon Cancer Primer

Colon cancer tumors form in the epithelial cells of the large intestine. Epithelial cells cover all of our body surfaces. The symptoms of colon cancer mirror those of Crohn's disease, making it difficult to diagnose in Crohn's patients. Typical colon cancer symptoms include rectal bleeding, blood in stool, change in bowel habits, alternating diarrhea and constipation, persistent abdominal bloating, feelings of fullness, cramping and chronic fatigue.

In the general population, colon cancer risk increases with age, personal history of polyps (growths on the intestinal wall), family history, and a diet high in fat and low in fiber. The National Cancer Institute predicts physicians will diagnose approximately 106,000 new cases of colon cancer in 2009.

Regular screening is important. Colon cancer grows slowly and early in the disease, there are few if any noticeable symptoms. The colonoscopy is currently the gold standard for colon cancer screening. During a colonoscopy, a gastroenterologist examines your colon using a lighted scope. If she finds small polyps, she'll remove them during the colonoscopy to reduce the risk they will become cancerous.

Crohn's Disease and Colon Cancer

Colon inflammation leads to higher risk of colon cancer. In fact, Inflammatory Bowel Disease (IBD) is the third highest risk factor for colon cancer. Inflammation of the small intestine also slightly increases your risk.

Your risk depends on how long you've had Crohn's Disease or Ulcerative Colitis, and the extent of colon damage. It begins to increase eight to 10 years after you've developed IBD. The longer you have IBD, the greater your risk for colon cancer. It doesn't matter if your Crohn's is active or in remission. A rare complication from IBD further exacerbates your risk. Primary Sclerosing Cholanitis is an inflammation of the bile ducts and puts you at potential risk for colon cancer sooner than the typical eight to 10 years.

Non-steroidal anti-inflammatory drugs, sometimes used to treat Crohn's patients, seem to lower the risk of non-cancerous colon cancer tumors in people who have Ulcerative Colitis. Researchers are not sure if they also reduce risk of cancerous tumors in Crohn's patients.

Everyone should begin screening for colon cancer at age 50, or earlier if a person has additional risk factors. Crohn's patients should discuss colon cancer screenings with their physician to see if he recommends earlier or more frequent screenings. Remember, early diagnosis of colon cancer leads to earlier, more effective treatment.



Expert Rev Gastroenterol Hepatol, 2 (6): 817-25 2008