Cancer and IBD: is there a link between them?

Inflammatory bowel disease (IBD), being an immune-mediated chronic disease, is associated with an increased risk of developing dysplasia and cancer, primarily due to chronic inflammation, which is an independent risk factor linked to the duration and extent of the disease¹.

However, the risk of patients with ulcerative colitis (UC) developing colorectal cancer (CRC) has steadily decreased over the past six decades due to therapeutic advances and close patient follow-up, but the extent and duration of the disease has been shown to increase this risk².

In addition, as with any person with or without other diseases, lifestyle, smoking, alcohol, diet, age or genetics are also factors to be taken into account when talking about the risk or tendency to suffer from some type of cancer. A healthy lifestyle incorporating a healthy diet, sport and avoiding alcohol and tobacco consumption is recommended.

Prevention, early detection and diagnosis

Chronic inflammation, a hallmark of IBD, has been identified as a key factor in the link to cancer. Constant inflammation can damage intestinal cells and increase the risk of genetic mutations that could lead to the development of cancer cells.

There are special situations where the risk of developing colon cancer is even higher, for example if you have primary sclerosing cholangitis, a family history of colorectal cancer or a personal history of colorectal cancer⁴. This raises a number of practical questions. The causes behind the changing trends in the epidemiology of UC-related CRC are complex. A key element may be early diagnosis and treatment of precancerous lesions by colonoscopic surveillance or, sometimes, prophylactic colectomy, while the third option is primary chemoprevention³.

Given this possible association, regular monitoring, colonoscopies to assess the status of the intestinal lining and/or incorporation into follow-up cancer screening programs may be recommended in some IBD patient profiles.

• https://pubmed.ncbi.nlm.nih.gov/32968366/
• https://onlinelibrary.wiley.com/doi/10.1111/apt.12651
• https://www.wjgnet.com/1007-9327/full/v14/i25/3937.htm
• https://pubmed.ncbi.nlm.nih.gov/35771958/