Patients with inflammatory bowel disease (IBD) that causes inflammation in the intestines, such as ulcerative colitis or Crohn’s Disease, and/or genetic colorectal cancer syndromes are considered to be at a high risk for developing colorectal cancer at some point in their lifetime. Such genetic syndromes include familial adenomatous polyposis (FAP), hereditary non-polyposis colorectal cancer syndrome (HNPCC), and Lynch syndrome. When considering if you have a genetic syndrome that increases your chance of developing colorectal cancer, it is important to consider if you have a family history of cancer, even non-colorectal cancers such as ovarian cancer, as these can contribute to your risk of having a genetic syndrome [1].

Colorectal cancer prevention for high-risk patients can vary some depending on what risk factors you have. For example, studies have shown that patients with IBD can take non-steroidal anti-inflammatory drugs (NSAIDs), such as aspirin, or cox-2 inhibitors to reduce the risk of developing colorectal polyps that can turn into cancer. However, since NSAIDs are blood thinners, they can also make you more prone to gastrointestinal bleeding and stomach ulcers, so it’s important to talk with your doctor before starting a NSAID regimen [1,2]. On the other hand, patients with genetic syndromes, such as FAP or Lynch syndrome, may elect to have their colon removed to prevent colon cancer; this complete removal of the colon is called a colectomy. It may also be recommended that the rectum is moved as well in a procedure called a proctocolectomy. Both of these routes will likely involve a stoma [1].  

In addition to NSAIDs and surgery, there are other healthy habits that are crucial for preventing high-risk patients from developing colorectal surgery. Smoking, heavy alcohol consumption, lack of physical fitness, and low-fiber, high-fat diets are all associated with increased colorectal cancer risk. It is important for all patients, but especially high-risk patients, to address these risk factors. If you are a smoker, it is highly recommended that you cease smoking and if you do drink alcohol, it is recommended to limit alcohol consumption. A high-fiber, low-fat diet combined with a regular exercise routine is also recommended [3].  

References 

1.     Preventive treatment for people at high risk for colorectal cancer. https://nyulangone.org/conditions/colorectal-cancer/treatments/preventive-treatment-for-people-at-high-risk-for-colorectal-cancer#:~:text=Medications%20Some%20studies%20have%20shown%20that%20medications%20such,for%20colorectal%20cancer,%20such%20as%20those%20with%20IBD (accessed May 2, 2022).

2.     Colorectal cancer prevention: How to prevent colorectal cancer. https://www.cancer.org/cancer/colon-rectal-cancer/causes-risks prevention/prevention.html (accessed May 2, 2022).

3.     Amrit Singh, M. B. B. S. Reducing your risk for colon cancer. https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/reducing-your-risk-for-colon-cancer (accessed May 2, 2022).