Which inflammatory bowel disease is associated with a higher risk of colon cancer?

Ulcerative colitis is associated with a higher risk of colon cancer due to the nature of the disease and the changes it induces in the colonic mucosa. Ulcerative colitis is characterized by continuous inflammation of the colonic mucosa, which leads to dysplasia, and ultimately, can progress to colorectal cancer. The risk of cancer increases the longer the duration of ulcerative colitis, especially after 8-10 years of having the disease. Regular surveillance colonoscopy is recommended for patients with long-standing ulcerative colitis to monitor for precancerous changes.

In contrast, Crohn's disease, while it can increase the risk of colorectal cancer, generally has a lower overall risk compared to ulcerative colitis. Diverticulitis and celiac disease do not have a direct association with a significantly increased risk of colon cancer; diverticulitis primarily affects the diverticula of the colon, and celiac disease primarily involves the small intestine. Therefore, in the context of these inflammatory bowel diseases, ulcerative colitis poses the most significant cancer risk.