Thanks
Gastroenterologist
Crohn's disease can affect any part of the gastrointestinal tract. The risk of bowel cancer is increased in a patient with crohn's disease, when its the colon that is affected predominantly by the disease. The risk factors for development of bowel cancer include, duration of the disease ( longer duration, higher risk), extent of the disease ( pan colitis has a higher risk than left sided colitis), degree of inflammation ( inflamed mucosa is at higher risk than healing/ healed mucosa), primary sclerosing cholangitis ( its presence increases the risk), smoking ( goes unsaid!) and family history of bowel cancer ( higher risk if there is a first degree relative with bowel cancer). The other risk factors would include obesity ( less common in patients with crohn's)
Risks can be reduced by stopping smoking and eating a healthy diet ( general advice).
In patients with Crohn's disease, a modest but definite reduction in colon cancer risk is achieved by 5-ASA medications.
Patients who have had colonic crohn's disease also should undergo surveillance colonoscopy commencing 8-10 yrs after the diagnosis of Crohn's disease ( and 1-2 yrly thereafter). This would enable early detection of dysplasia ( the harbinger to development of bowel cancer). Chromoendoscopic surveillance colonoscopy has now been adopted by several IBD units across Australia.
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Thank you for your question about Crohn's disease and bowel cancer.
Age and health history can affect the risk of developing bowel cancer.
The risk is greater if you -
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