Crohn’s disease is a long-term inflammatory bowel disease (IBD) that causes inflammation in the digestive tract. It affects more than half a million Americans, causing both physical and emotional challenges. Symptoms can include abdominal pain, fatigue, weight loss and diarrhea. People with Crohn’s disease also have a higher risk of developing colorectal cancer than the general population.

“People with Crohn’s disease are more likely to develop colorectal cancer due to the chronic inflammation in the digestive tract,” says Nebraska Medicine colon and rectal surgeon Rishi Batra, MD. “The high turnover of cells in the intestinal lining can cause irregularities.”

The risk level may depend on how long someone has had Crohn’s disease, the severity and which part of the digestive tract is affected. When caught early, colorectal cancer is very treatable.

Colorectal cancer risk factors

The risk for cancer increases the longer you’ve had Crohn’s disease. Other colorectal cancer risk factors are a combination of modifiable (can be changed or controlled) and non-modifiable (cannot be changed or controlled). This includes being over the age of 50 and having a family history of colorectal cancer. 

• Crohn’s disease that affects the colon (called Crohn’s colitis).
• Having had Crohn’s disease or ulcerative colitis for 8 to 10 years. 
• Type 2 diabetes. 
• Long-term smoking.
• Obesity and physical inactivity.
• Heavy alcohol use.

How to lower your colorectal cancer risk if you have Crohn’s

“The best way to reduce your cancer risk is to maintain good control of your Crohn’s disease and make sure you’re up to date on your colonoscopy screenings,” says Dr. Batra.

Regular screenings, like colonoscopies, can help detect early signs of cancer. Your health care provider can tell you how often to screen as this may depend on individualized patient care. Eating anti-inflammatory foods like those omega-3-rich foods, fruits, vegetables, whole grains and an overall healthy diet may be helpful. Other ways to reduce your risk include:

• Getting a colonoscopy every 1-2 years if you’ve had Crohn’s disease for 8 years or more.
• Quitting smoking.
• Exercising regularly.
• Paying attention to your symptoms and talking to your doctor about them.

When to see a health care provider

Early screening is key with Crohn’s disease and cancer risk. Monitor your symptoms and let your doctor know if new or worsening symptoms appear. Continue your medications and inform your health care provider if someone in your family develops colorectal cancer. 

“See your health care provider if you notice changes in your bowel habits,” says Dr. Batra. “Significant changes different from your usual Crohn’s symptoms should be checked. This can include blood in your stools, worsening cramping, abdominal pain or weight loss.” 

It’s always best to be proactive and reach out to your doctor sooner rather than later if something seems off. Early prevention can help avoid complications and ensure your treatment plan is effective.