New research suggests individuals with Crohn’s disease are at increased risk of bowel cancer and bowel cancer death.
Furthermore, patients with Crohn’s who have bowel cancer are more likely to die from bowel cancer than bowel cancer patients who don’t have Crohn’s.
The large study published online in The Lancet Gastroenterology & Hepatology analysed Registry results of 47,035 Crohn’s patients collected over a 48-year period.
Crohn’s disease is a chronic inflammatory condition of the gastrointestinal tract that is associated with abnormality of the immune system. Symptoms vary, but usually include abdominal pain and tenderness, frequent diarrhoea, rectal bleeding, weight loss and fever.
Researcher Jason K. Hou, MD, MS, of Baylor College of Medicine in Houston, said among Crohn’s patients, those diagnosed with the disease before age 40 were more likely to die from bowel cancer than Crohn’s patients diagnosed later in life who went on to develop bowel cancer.
“Healthcare providers need to better communicate risk of [bowel cancer] to patients with Crohn’s disease, and remove barriers to colonoscopy surveillance for patients at risk,” he wrote in a commentary that accompanied the research.
The study findings suggested bowel cancer surveillance should likely be focused on patients diagnosed with Crohn's disease before the age of 40 years, on patients with colon inflammation, and on those who have primary sclerosing cholangitis.
Within Australia, clinical practice guidelines for surveillance colonoscopy recommend the initiation of surveillance colonoscopy upon diagnosis of Crohn’s when primary sclerosing cholangitis (PSC) is present.
Among people with left-sided (distal) ulcerative colitis or Crohn’s colitis that affects at least one third of the colon, Guidelines suggest surveillance colonoscopy commence after 8 years of onset of symptoms.