Ulcerative Colitis Blog

Colorectal cancer (CRC) affects about 3% of the general population, but it is the most significant cause of increased death in patient's with UC. Early studies began following patients in the 1950's, concluding that the risk of CRC was not increased during the first decade of disease, but after 10 years the annual risk was 0.5-1.0%. Whether these estimates apply to today's, more recently diagnosed, patients is unclear, since early studies may have had design flaws which exaggerated the risk of cancer.

A recent study of patients with extensive UC, found a rate of dysplasia (pre-cancer) and cancer which was 8% at 20 years after diagnosis and 16% after 30 years; slightly lower than the rate of cancer alone reported in older studies. The cancer risk was 8% at 30 years and 11% at 40 years, <0.5% per year.

In addition to duration of disease, the following factors have been found to increase cancer risk:

1) Greater extent of colonic involvement (pancolonic proctitis)
2) Greater disease activity
3) Young age at onset
4) Primary sclerosing cholangitis (stricturing disease of the bile ducts)
5) Family history of colon cancer

Other than disease activity, the other risk factors are fixed, so what can we do to prevent cancer in UC? ...Next time, next time.

Please feel free to send a comment, ask a question, or suggest a topic.

Once you have had ulcerative colitis for several years it is necessary to have colonoscopies every couple of years in order to identify and prevent colon polyps and cancer. There are a few things that you can do to make sure that your colonoscopy is as productive and pleasant as possible:

1) By far the most important thing is to make sure that you have a clean colon. If the colon is not clean then the gastroenterologist will not have optimal viewing conditions to identify small polyps or masses. If the preparation is inadequate then the procedure will take longer than normal and may need to be repeated at another time, putting the patient through two procedures instead of one.

Different physicians prefer different purgative regimens, but you will always need to avoid solid food for at least 36 hours before the procedure. Clear liquids can be taken up until several hours before the colonopscopy. Clear liquids are foods which are liquid at room temperature and transparent to light such as apple juice, tea, popsicles, broth and jello. Milk is not a clear liquid, but coffee is as long as no milk is added. Make sure that you read the preparation instructions carefully and contact the doctor’s office if there is any confusion. It is far better to call ahead of time with a question than to have a poor preparation for the colonoscopy.

2) You should continue to take most medications as usual with a couple of exceptions. If you are diabetic then medications may need to be decreased for a couple of days before the colonoscopy to balance the decreased caloric intake. If you take blood thinners such as warfarin, injectable heparin, or even aspirin then you should discuss with your doctor whether or not to stop these medications.

3) Ask your doctor for a copy of the full procedure report including pictures. It is useful to have a hard copy of the report findings and future plans in case you cannot remember the details of the procedure. Furthermore, it is important to have these for your records if you ever have to switch doctors.