Colitis and Family History of Colon Cancer

Q:  I'm 40 years old, and three years ago had my first bout with colitis. In 1998, I had a colonoscopy after blood was discovered in my stool. The biopsies were negative for cancer and there were no polyps. I was treated for the colitis and have done well. Recently, I discovered a significant family history of colon cancer. Am I at greater risk and if so, what should I do to facilitate early detection?

A:  What a perceptive question. Your young age and recent negative colonoscopy are reassuring regarding your current status as being cancer free. The fact that you periodically have blood in your stools is a bit worrisome. On the one hand, you have a history of colitis that has bleeding as a manifestation. The recurring questions are whether this bleeding is due to the colitis or something else and secondarily when, and if, more aggressive interventions are required.

You will need, or perhaps you already have, a good working relationship with your family physician and a gastroenterologist. I would dutifully report each episode of bleeding to one or the other. At the very least, they may wish to check a blood count periodically while considering the need for future colonoscopies. There is also genetic testing available for colon cancer. I would encourage you to ask your gastroenterologist about this and follow his/her advice.

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