Colorectal cancer is the third most diagnosed cancer in the United States with prognosis for 2019 forecasting as many as 101 420 new cases of colon cancer and 44 180 of rectal cancer. And though about 90% of people diagnosed with colon cancer are over the age of 50, there is one group in particular for which the risk is higher due to no fault of their own like a high-fat diet of a smoking habit – both of which are risk factors not to be underestimated.

In the month of March, Colon Cancer Awareness Month, we at FindMeCure would like to shed some light on the connection between IBD and colon cancer. We’d like to specifically address some myths that seem to scare a lot of newly diagnosed people with IBD and sow unnecessary worries in their minds.

If you have been recently diagnosed with an IBD and are looking into possible outcomes and risks, we want you to know that IBD is not a one-way ticket to colon cancer and there are many factors that are still in your control. But let’s not get ahead of ourselves – here are the top 3 myths about IBD and colon cancer, debunked.   

Myth 1: IBD causes colon cancer

Let’s be clear on this one – IBD does not cause colon cancer. Now that’s out of the way, let’s talk risk factors. Although not directly related to colon cancer, IBD can indeed increase the risk but only so much. More than 90% of people with IBD never actually develop colon cancer. For people with ulcerative colitis, the risk significantly increases only after 8 to 10 years of living with this chronic disease. It’s also important to note that the risk is greater the longer IBD has gone untreated or inefficiently treated and by extension – the more the colon is damaged by it.

We wouldn’t want you to panic and we already established that an IBD diagnosis does not mean you will eventually get colon cancer but we have to be real about the numbers here – IBD is linked to an increase in the risk of colon cancer by about 2.6 times.

This number is difficult to pinpoint, though, because the risk depends on a number of factors that are not similar among Crohn’s patients: the site of inflammation – when Crohn’s only affects the small intestine, the risk is similar to the risk of people who are IBD-free; the time that has passed since the person has been diagnosed, as the risk increases approximately every decade; and the complications that have occurred during the course of treatment.

As you can see, to say that IBD is linked to colon cancer is to oversimplify a complex issue with a lot of factors at play. How high your risk of colon cancer is, depends on your specific case and you should address the disease prognosis with your doctor.     

Myth 2: There is nothing I can do

This one is also not true. Even people who live with an IBD can work with their medical team to lower the risk of colon cancer. In fact, you might be at an advantage compared to the general population. Here’s why: your doctor already know that your risk of colon cancer might be slightly higher than that of people who don’t have IBD, so they will recommend regular screening as a way to prevent the growth of cancerous cells.

Since cancerous cells in the colon usually develop from polyps that appear on the lining of the colon, regular screening can easily spot them so they can be removed before they cause trouble. But that’s not all.

Apart from regular screening, there are other things you can do to lower your risk. Whether you have IBD or not, a low-fat diet is usually recommended. The risk of colon cancer is higher in those who are overweight, don’t exercise and smoke, so regular physical activity, body weight in the healthy range for your build and your age as well as quitting cigarettes if you’re a smoker or resisting the temptation of an easy fix for your stress can all have a significant impact on your health.

What’s more, the earlier the treatment of IBD begins, the better the prognosis. You might think we’re biased toward biologics but there are many indications that beginning biologic treatment shortly after being diagnosed can prevent complications caused by inflammation. We are aware that biologics might not work for everyone but continuous research is bound to make a difference – improvements in biologics and biosimilars can not only make them easier to tolerate but also increase their efficacy.  

Myth 3: Additional screenings will become a burden on my time and finances

This, again, is not entirely true. You may be envisioning monthly check-ups on top of your already busy doctor’s appointment schedule but you should know that this is far from necessary. Although guidelines may be changing in the upcoming years based on expanding research, the recommended frequency of screening is about one every year or once every other year. But let us further elaborate on this.

In people who don’t have any form of IBD, the general recommendation is for screening to begin after age 50 with fecal occult blood tests once a year and a colonoscopy – once every 10 years. This is not what the guidelines recommend for IBD patients, however.

For people whose Crohn’s disease affects more than one-third of their colon and for those who live with ulcerative colitis (except in the case of proctosigmoiditis which doesn’t pose any additional risk) more regular screenings are the standard. The first main difference is that additional screening should begin between 8 and 10 years after the first symptoms of inflammation were experienced.

A colonoscopy with multiple biopsies should be followed by a ‘surveillance’ colonoscopy 1-2 years after in cases of increased risk and if all is clear, screening is to be repeated in 1-3 years.

As for the additional screening being a financial burden, this primarily depends on your insurance plan. As per the Affordable Care Act, health plans that were started after September 23, 2010, should cover screenings for colon cancer. The plans started before this date are guided by state laws and you should check with your insurance company.

Whatever your insurance plan, however, there is no fee to join a clinical trial if you’re looking for an alternative to treatments available now or you hope to be among the people who make the process of testing a new therapy easier. We have devoted our time to promoting clinical trials because they work. But you don’t have to take our word for it on that – just scroll down on our blog to read Holden’s story and see for yourself.

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