Colorectal Cancer (CRC) Prevention Month

March is Colorectal Cancer (CRC) Prevention Month Now is a great time to review your risk for CRC with your healthcare provider. People with ulcerative colitis, or Crohn's disease involving the colon, are at an increased risk of developing CRC. However, it is important to note that CRC is preventable and highly treatable in the early stages. Before CRC develops, precancerous tissue can be seen and removed, thereby reducing the risk of that tissue progressing to cancer. Thus, regular screenings and early detection are crucial. COLORECTAL CANCER Colorectal cancer (CRC) can occur anywhere in the l arge intestine (colon and rectum), and is the second-leading cause of cancer-related deaths in this country. While this statistic is scary, it is important to know that CR C is preventable and highly treatable in the early stages. Before CRC develops, precancerous tissue can be seen and removed , thereby reducing the risk of that tissue progressing to can cer. Thus, regular screenings and early detection a re crucial. Inflammatory Bowel Disease (IBD) & CRC Ulcerative colitis and Crohn’s disease are chronic diseases that inflame the gastrointestinal (GI) tract. Chronic inflammation of the colon can damage the lining of the colon over time, leading to an increased risk o f CRC. Therefore, people with ulcerative colitis or Crohn’s disease i nvolving the colon are at an increased risk of developing CRC compared to the general population. Even if your disease is in remission now, you remain at risk if you had significant inflammation in the past. However, despite this increased risk, it is important for you to understand that the vast majority of people with Crohn’s disease or ulcerative colitis will never develop CRC. Common Risk Factors Two key risk factors associated with increased CRC risk are disease duration and the extent of the colon involved. The risk for CRC does not start increasing until 8 to 10 years after you develop ulcerative colitis or Crohn’s disease involving the colon. People whose entire colon is involved h ave the greatest risk, and those with inflammation only in the rectum have the least risk. Some patients with IBD also h ave a chronic liver disease known as primary sclero sing cholangitis (PSC), which causes bile duct inflammation. If you have PSC, you may have a higher risk of developing CRC before the 8 to 10 year period. Signs & Symptoms CRC can have symptoms, but also can be completely without symptoms. Some of the symptoms below, such a s diarrhea or rectal bleeding, can be early warning signs of C RC in the general population. However, these sympt oms are difficult to assess in those with Crohn’s disease or ulcerati ve colitis because they may represent a flare-up of IBD. If you are experiencing any of these symptoms, speak to your doctor: • Change in the frequency of bowel movements • Diarrhea, constipation, or feeling that the bowel does not empty completely • Bright red or very dark blood in the stool • Stools that are narrower than usual • General stomach discomfort such as frequent gas pains, bloating, fullness and/or cramps • Weight loss with no known reason • Constant fatigue • Vomiting Diagnosis Although a colonoscopy is effective at diagnosing cancer of the colon, it is important to know that the purpose of screening and surveillance is to detect precancerous tissue and remove it, thus preventing it from progressing to cancer. Screening Recommendations CRC risk applies to patients with active or inactive IBD. CRC risk also depends on the length of time a person has had IBD, as well as the condition of the colon. That is why it is important to see your doctor for a routine colonoscopy every 1 to 3 years once you have had ulcerative colitis or Crohn’s disease involving the colon for 8 to 10 years. Decreasing Your Risk • If you have been diagnosed with Crohn’s disease or ulcerative colitis, see your gastroenterologist annually for a general check-up, regardless of how healthy you feel. • Discuss any concerns you may have with your doctor. • Report any changes in symptoms. • Help keep your disease and inflammation under control by staying on your medications, even when you ar e feeling well. • You and your doctor should review the medications you are currently taking. • Update your doctor on family history for colorectal cancer. • Although there is no cure for IBD, early detection is critical to reducing your risk for CRC. • Exercise and eat a healthy diet. • Log onto the Crohn’s & Colitis Foundation of America’s website, www.ccfa.org , for more information about Crohn’s disease and ulcerative colitis. CHECKLIST: AM I AT RISK for CRC? Just about everyone is at risk for CRC. However, t here are several key factors that may put you at in creased risk. Risk Factors for Developing CRC (check all that app ly): Diagnosed with Crohn’s disease involving the colon or ulcerative colitis. Eight to 10 year history of Crohn’s disease or ulce rative colitis. A personal or family history of colorectal polyps o r colorectal cancer. A personal history of bile duct inflammation (primary sclerosing cholangitis). Genetic syndromes such as familial adenomatous polyposis (FAP) or hereditary nonpolyposis colon cancer (HNPCC). Appearance of polyps or bumps in the colon. Appearance of dysplasia (changes in cells that are precursors of cancer) of the colon or rectum. If you’ve checked any of the boxes in the above che cklist, take this fact sheet to your next doctor’s appointment. Speak with your doctor about your risk factors for developing colorectal cancer and what you can do to reduc e your risk To learn more, check out our Colorectal Cancer Fact Sheet, and contact the IBD Help Center at info@ccfa.org for further information on prevention.