Colon Polyps

Main Types Of Colon Polyps:

  • Adenomatous - can develop into colorectal cancer, depending on the size (greater than 1 cm increased risk of progression to carcinoma) and type. There are three types: tubular, tubulovillous and villous. The polyp can be flat (sessile) or pedunculated (attached to a stalk). The degree of villous component of the adenoma correlates with the risk of progression to carcinoma.
  • Hyperplastic - usually small, rarely becomes malignant.
  • Inflammatory - may be associated with ulcerative colitis-considered benign, but having ulcerative colitis increases the overall risk of colon cancer.

How Are Colon Polyps Diagnosed?

Polyps usually are discovered by routine screening tests, such as fecal occult blood test, or sigmoidoscopy. If a colon polyp is observed, a complete exam by colonoscopy is recommended to detect and remove polyps elsewhere in the colon.

Who Is At Risk For Colon Cancer?

All adults are at risk. Colon cancer risk increases with age. It is estimated that colon cancer will strike 1 in 10 couples during their lifetime.

How To Prevent Colon Cancer?

Early and regular colorectal screening can prevent colon cancer by detecting and removing the adenomatous polyp, while it is in the pre-malignant state. Many studies are ongoing, but preliminary studies show:

  • Healthy diet with reduced animal fat
  • Increased amounts of vegetables and fiber
  • Low-dose aspirin per day may be helpful
  • Multi-vitamin, calcium and folic acid

What Are The Symptoms Of Colon Cancer?

Colon cancer is a silent disease, usually causing no symptoms until in a very advanced stage. If you experience any of the following signs or symptoms, see your doctor:

  • Rectal bleeding or pain
  • Change in regular bowel habit
  • Unexplained anemia, weight loss
  • New onset of lower abdominal pain

What Are The Symptoms Of Colon Polyps?

Most colon polyps do not produce symptoms. The larger the polyp, the more likely it is to cause symptoms, such as rectal bleeding.

Average Risk:

Every adult defined as age 50 or over with normal physical exam, without symptoms, no family history of colorectal cancer or colorectal polyps, and three consecutive negative fecal occult blood tests.

Recommendations:

  • Colonoscopy every 10 years starting at age 50, age 45 for African Americans.
  • Annual fecal occult blood tests (3) plus sigmoidoscopy every 5 years.

Please note: If an annual fecal occult blood test card is positive, a colonoscopy should be performed regardless of the number of cards that are positive.

Moderately Increased Risk:

Persons with moderately increased risk are defined as those having a first degree relative (mother, father, or sibling) with colorectal cancer diagnosed at age 60 or older.

Recommendations:

  • Colonoscopy every 10 years starting at age 40
  • Annual fecal occult blood tests plus sigmoidoscopy every 5 years

High Risk:

High risk person is defined as having two or more first degree relatives (mother, father or sibling) with colorectal cancer diagnosed at less than 60 years of age, family history (parent, sibling, or child) of colon cancer or Adenomatous colon polyp, Familial Polyposis Coli Syndrome, Familial Cancer Syndrome, personal history of colon polyps, or personal history of Crohn’s Disease or Ulcerative Colitis.

Recommendations:

  • Colonoscopy starting at age 40 or 10 years less than the youngest affected relative whichever is earlier.
  • Repeat colonoscopy every 3 to 5 years.