Adults with cystic fibrosis (CF) face a 5–10 times higher risk of developing colorectal cancer (CRC) compared to the general population, with an even greater risk — up to 20 times higher — for those who have received a lung or solid organ transplant. Due to this increased vulnerability, early and routine screenings play a critical role in reducing cancer risk.
Why Are People with CF at Higher Risk?
While the exact reasons are still being studied, researchers believe the CFTR gene mutation may contribute to an increased likelihood of polyp formation and faster progression to cancer. Given these risks, regular colonoscopies starting at age 40 (or as early as 30 for transplant recipients) are strongly recommended.
The Role of Colonoscopy in Prevention
A colonoscopy is the most effective screening tool, allowing doctors to detect and remove pre-cancerous polyps before they develop into cancer. Unlike stool-based home tests, colonoscopy is the only method proven effective for CF patients due to their unique gastrointestinal challenges.
Screening Guidelines for People with CF
- CF patients without a transplant: Begin screening at age 40 and repeat every five years unless otherwise advised.
- Transplant recipients: Begin screening at age 30 (or within two years post-transplant) and follow up as recommended.
- If symptoms arise (blood in stool, unexplained pain, weight loss, or anemia): Screening should be discussed with a CF care team immediately, regardless of age.
Coordinating Care with a CF Team
Since CF patients may require modified colonoscopy prep and sedation plans, open communication between CF specialists and gastroenterologists is essential. Proper bowel preparation is especially crucial, as CF patients often have thicker mucus buildup in the intestines, making standard prep methods less effective.
This growing body of research highlights the urgent need for awareness and action. By prioritizing regular screenings and early detection, people with CF can significantly reduce their risk and improve long-term health outcomes.
