What is IBD?
Irritable bowel syndrome is a chronic, inflammatory disease that affects either the small or large intestine. According to the Crohn’s and Colitis Foundation of America, it is caused by an immune reaction to environmental factors, such as bacteria, viruses and fungi. Smoking and the use of antibiotics may trigger the disease. There is also some evidence to support that it can run in families.
The two main forms of IBD are Crohn’s disease and ulcerative colitis. Crohn’s disease can affect any part of the gastrointestinal (GI) tract, while ulcerative colitis affects the colon and rectal area. Both cause symptoms such as abdominal pain, diarrhea, fever and weight loss.
There are a number of effective treatments for IBD. For mild cases, antibiotics and aminosalicylates, which help control inflammation, are used first. For more severe cases and for people whose symptoms are not controlled with the first line treatments, doctors might prescribe immunomodulators, which reduce the response of the immune system, and corticosteroids for inflammation.
The link between IBD and skin cancer
Researchers at the Mayo Clinic did a comprehensive review of studies on IBD and found that having IBD increased the risk of developing melanoma by an average of 37 percent. For those with Crohn’s disease, the risk was about 50 percent higher and for ulcerative colitis the risk was 23 percent higher than those without IBD.
The scientists did not determine the exact reason for this connection, but because people who were on immunosuppressants were found to have the highest risk, they do believe that the immune system is involved. The researchers believe that the same immune functions that cause IBD might also allow melanoma to grow and develop.
Several previous studies have also shown a link between IBD and a higher incidence of skin cancer:
A study published in the journal Gastroenterology in 2011 looked at about 9,600 people with IBD and found those with IBD were 20 percent more likely to develop basal cell carcinoma. Those who were taking thiopurines, a type of immunosuppressant medications, had an increased risk of developing squamous cell carcinoma.
A review published in Clinical Gastroenterology and Hepatologyfound that people with IBD were more likely to develop non-melanoma skin cancers than those without IBD. This review also found that people taking thiopurines were most at risk.
A study published in 2012 found that people with IBD were at increased risk of developing both melanoma and non-melanoma skin cancers. Those with Crohn’s disease were more at risk than those with ulcerative colitis. As with other studies, researchers found that people treated with thiopurines had a higher risk of non-melanoma skin cancer; however, they also found that those treated with biologics had a higher risk of developing melanoma.
What you can do
Study after study shows that those with IBD, especially when using immunosuppressant medications, are at a higher risk of developing skin cancer. While this might scare people away from these types of medications, you shouldn’t assume that stopping is the right answer.
Talk to your GI doctor about the risks versus the benefits of your medication. Your doctor can help you determine whether continuing these medications is in your best interest. The Crohn’s and Colitis Foundation suggests annual skin exams when taking these medications.
Make sure you practice safe sun behaviors. This means using sunscreen every day, limiting your time out in the direct sun and dressing appropriately when you are in the sun to keep your skin protected.
See your dermatologist once a year. While self-exams are important, make sure you schedule — and keep — an annual professional skin exam to detect potential skin cancers as early as possible.
More on skin cancer:
Eileen Bailey is a freelance health writer. She is the author of What Went Right: Reframe Your Thinking for a Happier Now, Idiot’s Guide to Adult ADHD, Idiot’s Guide to Cognitive Behavioral Therapy, Essential Guide to Overcoming Obsessive Love, and Essential Guide to Asperger’s Syndrome. She can be found on Twitter @eileenmbailey and on Facebook at eileenmbailey.