Crohn's Disease And Colon Cancer: What You Need To Know

If you've been diagnosed with Crohn's disease, you may be concerned about your risk for colon cancer. While increased risk is often true, most people with Crohn's don't get colon cancer. And there are also things you can do to lower your risk.

Here, we'll cover what Crohn's disease is, its symptoms, and the complications it can cause. And, we'll discuss the connection between Crohn's disease and colon cancer.

What is Crohn's disease?

Crohn's disease, similar to ulcerative colitis, is an inflammatory bowel disease (IBD) that causes chronic inflammation of the digestive tract. Crohn's disease damages the intestines, causing them to become irritated, red, and swollen. It causes damage to the entire bowel wall from mouth to anus, although it most commonly involves the small bowel and colon.

Crohn's disease is an autoimmune disease. In people with the disease, the immune system recognizes the lining of the digestive tract as foreign and attacks it, causing inflammation.

Acute episodes can present as fevers, abdominal pain, and diarrhea with mucous or blood. Crohn’s can also cause scarring, narrowing of the bowel, and fistulas. A fistula is an abnormal passageway that connects two body parts that don't usually connect. This includes connections between the bowel and skin, bladder, vagina, or loops of the bowel. Fistulas often contain intestinal bacteria and other infectious material.

Other common symptoms of Crohn's disease include:

• Gas and bloating

• Nausea or vomiting 

• Weight loss

• Low energy

• Constipation

• Delayed growth and development in children

• Mouth ulcers

• Painful swallowing

Each person's experience with Crohn's disease is different. This is because the inflammation caused by the disease can involve different areas of the digestive tract in different people.

For some people, Crohn's disease can be debilitating and extremely painful. It can also lead to life-threatening complications, such as severe infections, malnutrition, and colon cancer.

Crohn's disease can also cause symptoms outside the digestive tract. While many people with Crohn's disease have inflammation in the bowel, about 30 to 40% of¹ Crohn’s sufferers have Crohn's disease symptoms outside their digestive tracts. These may present at the same time as an acute gastrointestinal episode or separately. This is because the disease is a whole-body condition that can attack other systems and organs besides the bowel.

Some systemic features of Crohn’s disease include:

• Rashes

• Joint pain

• Arthritis

• Kidney stones

• Gallstones

• Redness or pain in the eyes or vision changes

• Fever

• Fatigue

Does having Crohn’s increase your risk of colon cancer?

While most people with Crohn's don't get colon or colitis cancer, the inflammatory disease can raise your risk² of developing cancer.

About 1% of people³ with Crohn's disease end up developing colon cancer.

The link between the two conditions is inflammation. Crohn's causes high levels of inflammation in the intestines. As a result, that inflammation could make it more likely for abnormal cells - that could become cancerous - to develop in the gastrointestinal (GI) tract.

A few factors can further increase your risk for developing colon cancer: the age when you were first diagnosed with Crohn’s, the area of the bowel it affects, and how long you’ve had Crohn’s disease. 

The longer you've had Crohn's, the higher your risk for developing colon cancer. Around 3%⁴ of people living with Crohn's disease for at least ten years developed colon cancer. However, that number rose to 8% for those who had Crohn's for 30 years. To put that into perspective, the lifetime risk⁵ of developing colon cancer is about 4%.

The risk of colorectal cancer if you’re diagnosed with Crohn’s before the age of 30 is 20 times higher than if you’re diagnosed after 30. In Crohn’s patients whose disease only affects the colon, their risk of colorectal cancer is doubled further compared to patients who have a more widespread disease pattern.

How can you reduce your risk of developing colon cancer?

There are several ways to lower your colon cancer risk if you have Crohn’s. They include:

Sticking with your treatment plan

Even if you're not feeling symptoms of Crohn's, continue to take your medication(s). This will reduce inflammation, which helps reduce your risk of developing complications such as cancer. 

Keeping up with health screenings

Getting regular colonoscopies can check for signs of colon cancer and thus, reduce your chances⁶ of developing it. Precancerous polyps often develop with colon cancer. By removing them, doctors can sometimes stop colon cancer before it starts.

Eating the right foods

An anti-inflammatory diet can reduce inflammation⁷, which can, in turn, reduce the risk of colon cancer. This diet includes eating lots of fruits, vegetables, whole grains, beans, and fish.

Avoid inflammatory⁸ foods and ingredients like sugar, high-fructose corn syrup, vegetable and seed oils, red and processed meat, fried or greasy foods, and carbonated beverages.

Getting regular exercise

Regular physical activity can reduce your risk of colon cancer⁹. Most physically active adults can reduce their risk of colon cancer by as much as 24%¹⁰.

Exercise lowers cancer risk by controlling weight and strengthening the immune system. Even minimal amounts of moderate exercise reduce risk.

Making certain lifestyle changes

Drinking alcohol and smoking can worsen Crohn's disease symptoms and increase the risk of colon cancer¹¹. By not smoking and limiting alcoholic drinks to no more than one a day, you can reduce your chances of getting colon cancer.

How often should people with Crohn's be screened for colon cancer?

Because having Crohn's disease can increase the risk of colon cancer, it's important to get regular screenings.

If you've been diagnosed with Crohn's and have had it for 15 to 25 years¹², it's best to start getting a colonoscopy every two years. If you've had the disease for longer than 25 years, you should have annual colonoscopies.

Since every individual is different, it's a good idea to talk to your doctor about the best colon cancer screening schedule for your particular situation.

Symptoms of colon cancer you should look out for if you have Crohn's

•  Diarrhea

• Constipation

• Stringy, narrow stools

• Rectal bleeding or bloody stool

• A feeling that your bowel doesn't empty completely

• Weakness or fatigue

• Unexplained weight loss

• Abdominal discomforts such as cramps, gas, or pain

• Anemia

People with Crohn's may not notice symptoms of colon cancer because symptoms of both conditions can be similar. This is why it's so important to get regular screenings for colon cancer to detect problems early.

Dealing with Crohn's disease can be stressful and taxing on your physical health and your mental health. Staying on top of your illness by getting regular treatment and screenings can reduce inflammatory symptoms, ultimately reducing the risk of colon cancer.

Learn about colon cancer prevention and how you can help reduce your risk.