How Digestive Diseases Affect Your Risk of Colorectal Cancer

Chronic inflammatory bowel diseases (IBD), like Crohn’s disease and ulcerative colitis (UC), do much more than cause daily discomfort.

These long-term conditions also raise the risk of developing colorectal cancer, especially when inflammation remains uncontrolled. Discover why this happens and how to lower your risk.

How Digestive Diseases Increase Colorectal Cancer Risk

Chronic gut inflammation is the main cause of increased risk for colorectal cancer with conditions like ulcerative colitis or Crohn’s disease. When inflammation affects the colon for years, the cells lining the intestine are repeatedly damaged and repaired. This can lead to genetic mutations over time.

“Chronic inflammation creates a field effect that changes the landscape of the colon, making cancer more likely to develop over time,” shares Jennifer Pierce, MD, a colorectal surgeon with ProMedica Physicians.

A field effect is when a large area of the colon lining becomes altered by carcinogens (in this case, inflammation). This makes the area more prone to developing cancers or abnormal tissue growths called polyps.

This risk is even higher for people who have ulcerative colitis along with primary sclerosing cholangitis (PSC). PSC is a type of chronic liver disease in which inflammation can allow bile acids into the colon. This irritates the colon and causes abnormal cell development to happen faster.

Key Risk Factors for Patients With IBD: Crohn’s Disease and Ulcerative Colitis

If you have inflammatory bowel disease, knowing what increases colorectal cancer risk can help you better protect your health. Several key factors play an important role.

Duration of disease.

The number of years someone has lived with their digestive condition strongly influences IBD-related cancer risk.

“It’s not a patient’s age that drives risk; it’s how many years they’ve lived with the disease,” notes Dr. Pierce.

Extent and severity of inflammation.

Cancer risk is higher when large sections of the digestive tract are affected or when inflammation is severe and persistent.

Coexisting conditions.

Conditions such as PSC — a chronic liver disease that increases inflammation risk — put you at a higher risk of colon cancer and require closer monitoring.

Understanding your risk is the first step. The next is knowing what you can do to lower it.

Ways To Lower Your Risk of Colorectal Cancer With Digestive Disease

Lowering your risk of colorectal cancer is possible. A combination of medical treatment, monitoring and lifestyle habits offers the strongest protection.

Control inflammation effectively.

Modern therapies, including biologics, can dramatically improve inflammation control. Biologics are protein-based drugs made from living cells. They target specific parts of the immune system to reduce inflammation.

“Better management of inflammation has led to a lower incidence of colorectal cancer in people with IBD,” explains Dr. Pierce.

Stay on schedule with colonoscopies.

Regular colonoscopies allow physicians to monitor inflammation, remove pre-cancerous polyps and take biopsies to check for any evidence of cancerous cells.

“Colonoscopies remain the most effective tool we have. Not just for finding cancers, but for preventing them,” shares Michael Basista, MD, a gastroenterologist with ProMedica Physicians.

Patients with a digestive disease are encouraged to begin regular screening colonoscopies eight years after diagnosis or symptom onset, and then continue screening every one to two years.

Dr. Basista also emphasizes the importance of choosing a colonoscopy over a stool test, especially for those with a chronic digestive disease. Colonoscopies not only detect cancer, they also detect conditions that may eventually lead to cancer, such as colon polyps and inflammation.

Build healthy lifestyle habits.

Lifestyle changes can make a real difference. A daily fiber intake of 25–30 grams, avoiding processed meats, maintaining a healthy weight, exercising, and limiting alcohol and tobacco can help reduce risk.

These habits support a healthier gut environment and can reduce chronic inflammation.

Digestive Disease Symptoms That May Signal an Issue

Colorectal cancer symptoms can resemble digestive disease flare-ups, making it difficult to know when something warrants more investigation.

Any new or worsening symptoms means it’s time for an evaluation. “Patients shouldn’t assume new or worsening symptoms are ‘just a flare.’ Sometimes those changes signal something more,” warns Dr. Pierce.

If you experience any of these symptoms for more than two weeks, you should schedule a visit with your doctor:

• Chronic diarrhea or major changes in bowel habits.
• Persistent rectal bleeding.
• Severe constipation.
• Abdominal pain.
• Unintentional weight loss.
• Fatigue or anemia.

If you’re experiencing symptoms, talk to your primary care provider or gastroenterologist. Seek immediate care if bleeding is heavy, pain is severe or symptoms worsen rapidly.

Never write off symptoms because of your age. Colorectal cancer is rising in younger adults, so no one is too young to have symptoms checked. It’s better to have the symptoms checked early to make sure there’s nothing else going on.

Taking Control of Your Digestive Health and Colon Cancer Prevention

Living with Crohn’s disease or ulcerative colitis can feel overwhelming. Regular treatment, routine colonoscopies, and paying attention to symptoms can prevent many cases of colorectal cancer. This can also help catch it early when it is easiest to treat.

“When colorectal cancer is present, we can’t change the diagnosis, but we can change the trajectory. Early action saves lives,” shares Dr. Basista.

Jennifer Pierce, MD 
Dr. Pierce is a colorectal surgeon with ProMedica Physicians. View her profile. 

Michael Basista, MD
Dr. Basista is a gastroenterologist with ProMedica Physicians. View his profile.