Doctors Emphasize Prevention, Screening for Ulcerative Colitis amid Higher Risk for Colon Cancer

Prevention and screening are key when it comes to ulcerative colitis and its association with a slightly higher risk for colon cancer.

Two decades ago, Jennifer Medina, now 46, noticed something with her body was off.

“I was originally diagnosed with ulcerative colitis in 2006,” Medina said. “It was because I was noticing blood in my stool, but that was really the only symptom I had.”

Things changed a few years later.

“I lost a lot of weight. It was very painful for me to eat, so I didn’t eat enough to maintain a healthy weight. I had bloody diarrhea, urgency, which meant you’re always making sure you know where a bathroom is, which is uncomfortable to live like that,” Medina said.

Medina’s diagnosis changed from colitis to Crohn’s disease, and without routine screening, she could have ended up with colon cancer.

“She’s one of those patients that had invisible dysplasia, pre-cancer in biopsies. And, as we’ve controlled inflammation and our scopes have improved, we’ve been able to see visible pre-cancer in that segment,” said Raymond K. Cross, Jr., MD, MS, AGAF, FACG, medical director of The Center for Inflammatory Bowel and Colorectal Diseases, part of The Melissa L. Posner Institute for Digestive Health & Liver Disease at Mercy. “We’ve been able to leverage advanced endoscopy, and you can take out more difficult, visible dysplasia. She’s complied with follow-up and been able to get those areas out, and she keeps her colon and her quality of life outstanding.”

According to Dr. Cross, after about 30 years of colitis, patients have about an eight percent risk of developing colon cancer. For the general population, he says that risk—over a lifetime—is about four percent, and he said inflammation is the cause.

“We have a number of effective medicines now that can control inflammation,” Dr. Cross said. “But when inflammation is not well controlled, there are a number of genetic changes that occur in the colon similar to spontaneous colon cancer; there are different genetic changes that increase a patient’s risk of colon cancer.”

Because Medina has followed her doctor’s orders, she has been able to get her life back.

“That has allowed my disease to remain in remission; it’s allowed me to go on and do two long-distance triathlons, many marathons, really live life to the fullest,” Medina said, adding that she currently goes for yearly colonoscopies. She hopes for a good outcome at her next one, after which she could change to getting a colonoscopy once every other year.

View Mercy gastroenterologist Dr. Raymond Cross’ interview regarding inflammatory bowel disease in women and the risk of colorectal cancer.