Colon Cancer And Ulcerative Colitis

Ulcerative colitis (UC) is a condition that causes chronic inflammation and sores to form in the lining of the colon. This type of inflammatory bowel disease often leads to cramping, the urgency to pass a stool, and bloody diarrhea.

Ulcerative colitis inflammation begins in the rectum, close to the anus, then spreads upwards and affects part of or the entire colon.

Distal or limited colitis means ulcerative colitis affects only the left portion of the colon, while pancolitis means it affects the entire colon.

Ulcerative colitis often starts between the ages of 15 and 30, is less frequent between 50 to 70, and affects both genders equally.

Having ulcerative colitis basically means that the body's immune system is attacking the colon and causing inflammation. Unfortunately, when the inflammation due to UC occurs for a long time, it results in changes in the colon lining cells, which can eventually become colon cancer. The cells grow out of control in the rectum or colon, where bowel content stops in the digestive system.

This article explains more about colon cancer and ulcerative colitis.

How UC increases the risk of colon cancer

Having UC increases the chances of getting some forms of colorectal cancer, often due to the inflammation it causes. Chronic inflammation puts people at risk of developing colorectal cancer in different ways.

1. It damages the genetic material in colon cells which can create mutations in these cells.

2. It increases the levels of certain molecules that can facilitate cancerous tumor growth.

3. It increases the risk of contracting viral and bacterial infections. These may interfere with the body's immune system and promote the growth and multiplication of cancer cells.

Percentage of people with UC who end up developing colon cancer

Colon cancer ranks fourth¹ among the most common cancers in the US. The risk of colon cancer is higher for patients with ulcerative colitis. Research estimates² an increased risk of 2%, 8%, and 18% after 10, 20, and 30 years of having UC, respectively. For this reason, people with UC must be vigilant in receiving colon cancer screening.

How often should people with UC receive colon cancer screening?

Since the risk of colon cancer increases over time in people with UC, it is important to receive regular colon cancer screenings. It enables the doctor to find polyps before they become cancerous, which makes them easier to treat.

Screening options for colon cancer include:

• A stool sample to examine for traces of blood

• Flexible sigmoidoscopy where a tube with a small camera enables a doctor to examine the rectum and lower portion of the colon

• Colonoscopy whereby a tube with a small camera enables a doctor to examine the rectum and entire colon

• Computed tomography (CT) colonography, a powerful virtual colonoscopy that combines x-rays and computer technology

A colonoscopy is the most common test that helps doctors find any suspicious cells and tissues before they become colon cancer. Regular colonoscopy screenings could help reduce the risk of developing or dying from colon cancer. A study revealed that the risk of developing this cancer dropped by 42%³, while that of dying dropped by 64% for people with IBD (Inflammatory Bowel Disease).

It is recommended that patients with UC consult their doctors about starting with regular colonoscopies eight years after the initial symptoms appear or at the time of diagnosis with UC. In general, people are advised to get a colonoscopy every 1-3 years⁴. However, some people may need to test more or less often depending on factors such as:

• Family history of colon cancer

• Age of diagnosis

• The extent of inflammation and damage to the colon

How can people with UC help reduce their risk of colon cancer?

Some factors that increase the risk of colon cancer include a family history of the disease, age, race and ethnicity⁵, and certain genetic syndromes such as Lynch syndrome⁶ or polyposis syndromes. These are factors beyond your control. However, the American Cancer Society⁷ (ACS) says that controllable lifestyle factors contribute to 55% of colon cancer in the United States.

So, people with UC can reduce their risk of colon cancer by making the following lifestyle changes:

Avoid drinking alcohol

The risk of colon cancer increases with drinking alcohol, whether the consumption is moderate, heavy, or light. It is recommended that men do not have more than two alcoholic beverages a day and women no more than once a day.

Eating a healthy diet

Consumption of a high-fat diet with too much processed or red meat can increase the risk of colon cancer. Therefore, you should try to limit red meat intake, including steaks and burgers and processed meats such as sausage, hot dogs, and bacon. Always aim for a diet rich in fiber, fruits, and vegetables.

Exercising regularly

Colon cancer is closely tied to physical activity. People who spend a lot of time lying down or sitting are at a higher risk of developing colon cancer. Any form of exercise is helpful, for example, riding a bike, running, or walking. Thirty minutes of exercise a day are highly recommended for health in general.

Avoiding smoking

The ACS⁸ reports that smoking tobacco is associated with colon cancer. About 12% of cancer cases in the United States are former or current smokers.

Taking preventive medication

Taking nonsteroidal anti-inflammatory drugs (NSAIDs) often and for a long time is associated with a reduced risk of colon cancer, especially for people below 70 years with a healthy weight. However, people should not use these medications before consulting with a doctor as they come with side effects.

Symptoms of colon cancer to look out for if you have UC

People with UC should look out for symptoms of colon cancer and discuss them with their doctor right away.

They include:

• Thinner stools than normal

• Excessive gas

• Any changes in bowel movements

• Vomiting

• Bloating or fullness feeling

• Blood in the stool

• Unanticipated weight loss

• More tired than usual

• Diarrhea or constipation

The lowdown

A chronic condition like ulcerative colitis requires that you have regular checkups with your doctor to ensure you stay on top of its management. It is also important to be aware of any warning signs of colon cancer.

Reducing cancer risk in people with UC is all about minimizing inflammation. You should discuss with your doctor the best way to manage the condition.

Making positive lifestyle changes can also help reduce the risk of colon cancer.