Overview

Inflammatory bowel disease (IBD) is a term used to describe medical conditions such as:

• ulcerative colitis 
• Crohn’s disease 

These are long-term conditions involving inflammation of the gut.

People with IBD have a slightly increased risk of developing bowel (colorectal) cancer compared with the general population. 

The risk of developing bowel cancer depends on how severe the IBD is and how long you have had it. Other risks include a family history of bowel cancer and if you have a liver disease called primary sclerosing cholangitis (PSC).

Regular screening by colonoscopy is important for preventing bowel cancer in people who have had IBD for a long time.

Surveillance colonoscopy

A colonoscopy allows specialists to look for early changes in the large bowel (colon) before cancer develops. This is called a surveillance colonoscopy. It detects changes at a very early stage when they are more likely to be treated and cured. 

In most cases, there are changes in the bowel lining before cancer develops which can be detected with biopsy samples. These are precancerous changes called polyps. These polyps can develop abnormal cells (dysplasia). Once polyps or dysplasia occurs they can progress to cancer over a number of years.

How often you have a surveillance colonoscopy depends on how severe the IBD is and if there are any other risk factors. You might have one every year, every 3 years or every 5 years.

We recommend surveillance colonoscopy for people where:

• IBD affects more than a third of the large bowel (colon) 
• it has been 8 to 10 years since their diagnosis of IBD

Preparing for a colonoscopy

We will explain the risks and detailed information about having a colonoscopy.

Your bowel needs to be empty for the colonoscopy. You will need to follow our diet advice and bowel preparation so that the specialist can see the lining of your bowel. 

Results

If polyps or dysplasia are found during your colonoscopy we usually try to remove them by using an endoscopy procedure. 

In rare cases we may recommend surgery to remove your large bowel and tissue where cancer might develop in the future. Your surgeon will discuss this with you in detail if surgery is recommended. 

You can help to reduce the risk for developing bowel cancer by making sure you take the medication prescribed by your gastroenterologist. This helps reduce inflammation in the bowel and reduces the risk of developing bowel cancer.

Check-ups

It is important that you attend all appointments that we request or arrange for you, even when your IBD is in remission. These appointments will be to see your doctor regularly for check-ups and for colonoscopies. This makes sure that you remain on the most appropriate treatment. 

If you have any changes in symptoms at any time, speak to your doctor immediately. 

Useful information

Crohn’s and Colitis UK crohnsandcolitis.org.uk

Bowel cancer UK bowelcanceruk.org.uk