IBD-related colorectal cancer risk raised by chronic inflammation, immunosuppressive therapy

Inflammatory bowel disease-related colorectal cancer risk is raised by chronic inflammation and immunosuppressive therapy. The review was conducted by Dr. Laurent Beaugerie from Hôpital Saint-Antoine in Paris and Dr. Steven H. Itzkowitz from Icahn School of Medicine at Mount Sinai.

In the news release, the researchers said, “Among the chronic inflammatory diseases that often require the prolonged use of immunosuppressants, [inflammatory bowel disease] is an intriguing model because immunosuppressants may reduce the incidence of inflammation-related cancers through their anti-inflammatory effects or promote immunosuppression-related cancers.”

Individuals with inflammatory bowel disease (IBD) have 1.5 times higher risk of developing colon cancer, compared to the general population.

A previous meta-analysis study has found that an improved control of inflammation, along with frequent colonoscopies and the use of chemopreventive 5-aminosalicylates (5-ASAs), promoted a decrease in the higher risk for colon cancer in IBD patients. However, other studies have made conflicting conclusions with regards to the preventative effect of 5-ASAs.

Roughly 15 percent of colon cancers are diagnosed within the first seven years of IBD diagnosis. It is also well known that chronic inflammation plays a role in colitis-associated cancer.

Data on Crohn’s disease suggests that patients with Crohn’s have a 20 to 30 percent higher risk of bowel adenocarcinoma in ileal lesions after eight years of diagnosis, compared to the general public. The only preventative measure in Crohn’s patients is to remove the ileal lesions.

Inflammatory bowel disease and its link to colorectal cancer

Annually, 147,000 new colon cancer cases are diagnosed, leading to 57,000 deaths. Inflammatory bowel disease, like ulcerative colitis and Crohn’s disease, causes inflammation along any part of the digestive system from the mouth all the way to the anus. Individuals with IBD are at a higher risk of colorectal cancer, compared to the general public.

Two main factors affecting the risk for colon cancer in IBD patients are the duration of the disease and the extent to which the colon is involved. The risk of colon cancer doesn’t begin to rise in IBD patients until eight to 10 years post-diagnosis. Furthermore, if the entire colon is inflamed or affected, that increases the patient’s risk of colon cancer, too.

A complication of IBD is chronic liver disease, which also plays a role in the risk of colon cancer. This form of liver disease involved in IBD leads to inflammation of the liver ducts that help drain bile. If bile cannot be drained, the risk of colon cancer may rise.

Common signs of colorectal cancer include:

• Changes in bowel movement frequency
• Diarrhea, constipation, or feeling as if the bowel does not empty completely
• Bright red or very dark red stool indicating blood
• Stools that are narrower than usual
• General stomach discomfort
• Unintentional weight loss
• Constant fatigue
• Vomiting

If you have IBD and begin to notice these symptoms, speak with your doctor immediately to get tested for colorectal cancer to begin treatment right away.