Colitis and Colorectal Cancer

Ulcerative colitis is known to have a significant impact on quality of life, but did you know it could also increase your risk of colorectal cancer?

Understanding the link between colorectal cancer and colitis is crucial for patients and healthcare providers alike. To help, below we’ll explore what ulcerative colitis is, how it is connected to colorectal cancer, and why regular screenings are vital.

What is ulcerative colitis?

Ulcerative colitis is a type of inflammatory bowel disease (IBD) that specifically targets the lining of the large intestine (colon) and the rectum. It causes long-lasting inflammation and sores (ulcers) in the digestive tract, leading to symptoms such as abdominal pain, cramping, diarrhoea, and rectal bleeding.

The condition can vary in severity, with some patients experiencing mild symptoms, while others endure severe, debilitating flare-ups.

The exact cause of the condition is unknown, but it is believed to result from an abnormal immune response that triggers inflammation in the gastrointestinal tract. Factors such as genetics, environmental influences, and an overactive immune system are thought to play a role in its development.

Living with ulcerative colitis often means managing symptoms through a combination of medications, lifestyle changes, and, in some cases, surgery. While treatment can significantly improve quality of life, the chronic nature of the disease requires ongoing vigilance and care.

What is the link between ulcerative colitis and colorectal cancer?

Those with ulcerative colitis have a higher risk of developing colorectal cancer compared to the general population. This increased risk is primarily due to the chronic inflammation that characterises ulcerative colitis. Over time, persistent inflammation can cause changes in the cells lining the colon, increasing the likelihood of malignant transformations.

Several factors influence the degree of cancer risk in ulcerative colitis patients, including:

Duration of disease – The longer a person has ulcerative colitis, the higher their risk of colorectal cancer. Typically, the risk begins to rise significantly after 8-10 years of disease activity.

Extent of colon involvement – Patients with extensive colitis (inflammation affecting the entire colon) have a greater risk compared to those with limited disease.

Family history – A family history of colorectal cancer or other cancers can further increase the risk.

Severity and frequency of flare ups – More frequent and severe flare ups of inflammation are associated with a higher risk of cancer.

Presence of Primary Sclerosing Cholangitis (PSC) – Patients with ulcerative colitis who also have PSC, a liver condition, are at an even higher risk of developing colorectal cancer.

Understanding these risk factors is crucial for developing a proactive approach to cancer prevention and early detection.

Colorectal cancer screenings

Given the heightened risk of colorectal cancer in ulcerative colitis patients, regular screenings are essential. Early detection of precancerous changes or cancer itself, significantly improves treatment outcomes and survival rates.

Screening can identify abnormal changes in the colon’s lining before they develop into cancer. This allows for early intervention and more effective treatment. They also help monitor the extent and severity of inflammation, providing critical information for adjusting treatment plans and reducing cancer risk.

Detecting and removing precancerous polyps during a colonoscopy can prevent them from developing into cancer.

For patients with ulcerative colitis, regular colonoscopy screenings offer reassurance that any potential complications are closely monitored, managed and treated early on. For expert advice and to organise a screening, book an appointment with Mr Michael Stellakis today.