A colon polyp is a fleshy tumor in the form of a small clump of cells that occurs on the inside lining of the colon and can range from small to large, as well as benign to malignant. Although the majority of colon polyps are initially benign, some can become malignant over time if not removed. Eventually, malignant colon polyps can lead to colorectal cancer.
Colon polyps can either be adenomatous or non-adenomatous. Adenomatous colon polyps are pre-cancerous, meaning these polyps have the potential to turn into colorectal cancer. Adenomatous polyps can exhibit dysplasia (ranging from low-grade to high-grade), which is the abnormal cellular growth of the polyp, indicative of the very early stages of cancer. Non-adenomatous polyps are all non-cancerous and include hyperplastic polyps, inflammatory polyps, lipomas, and lymphoid aggregates; although hyperplastic polyps comprise the vast majority.
There are four main growth patterns of polyps: tubular, villous, tubulovillous, and serrated. The former three occur only in adenomatous polyps, and the latter, serrated, can occur in either adenomatous or non-adenomatous polyps. Different growth patterns are significant for different risks of developing colorectal cancer.
Colorectal cancer is cancer of the large intestine; the colon is the large intestine and the rectum is the last several inches of the colon. The majority of colorectal cancer begins as one or more benign colon polyps, which become malignant over time. Colorectal cancer is one of the leading causes of cancer in the US. Fortunately, it is also one of the most preventable; when detected early, more than 90% of patients can be cured.
Colon polyps do not cause any symptoms. This is one of the reasons screening colonoscopies with a gastroenterologist are very important in those over 50, or in those with an extensive family history of colon polyps or colon cancer.
The symptoms of colorectal cancer vary depending on the stage, size, and location of the cancer. Some people experience no symptoms at all in the early stages of the disease. Common symptoms include:
Risk factors for the development of colon polyps and colorectal cancer depend on a number of factors, including age, personal medical history, genetic factors, and environmental factors. It is the combination of these factors that determine an individual’s likelihood to develop malignant polyps and colorectal cancer.
Although people at any age can develop colorectal cancer, statistically, the risk increases dramatically once a person reaches age 50. About 90% of all people diagnosed with colorectal cancer are over 50 years old.
Personal Medical History:
A personal history of malignant polyps and/or colorectal cancer increases future risk of developing colorectal cancer. The increased risk varies depending on the size, specific type, and number of polyps, as well as the age at which the colorectal cancer developed.
A personal medical history of inflammatory bowel disease, which includes Crohn’s disease and ulcerative colitis, also increases the risk of developing colorectal cancer.
A family history of malignant polyps and/or colorectal cancer increases the risk of developing colorectal cancer. The risk is increased if the family member is a first-degree relative and if he/she was diagnosed with colorectal cancer before the age of 45.
There are multiple inherited syndromes that can drastically alter the likelihood of developing malignant polyps and colorectal cancer. The two most common genetic syndromes are hereditary familial polyposis and lynch syndrome (hereditary non-polyposis colorectal cancer). Hereditary Familial Polyposis is a condition in which the entire colon is studded with hundreds, even thousands of polyps. This begins at a very early age, even under ten years old. Virtually every patient will eventually develop colorectal cancer. The only known preventive treatment is surgical removal of the colon. Fortunately, the condition is not common. Lynch syndrome is slightly more common and increases the likelihood of malignant polyp formation in any close blood relatives. Family history and close screening is therefore very important.
There are a number of environmental factors (influences that are dependent on diet, nutritional intake, and behavioral lifestyle choices) that can affect one’s risk for colorectal cancer.
Factors thought to increase one’s risk:
Factors thought to decrease one’s risk:
Detection of colon polyps and colorectal cancer relies upon a painless procedure called a colonoscopy. Once sedated, a thin, flexible, lighted tube with a camera on the end will be placed through the rectum in order to visualize the lower GI tract. Biopsies will also be taken at this time of the lining of the bowels and, if present, of any polyps, to look for any abnormalities (like pre-cancerous or cancerous changes). If polyps are present, they will most often be painlessly removed.
The key to prevention of colorectal cancer is regular screening. All individuals 50 years of age and older should have a screening colonoscopy. After this, colonoscopies will be scheduled at regular intervals every certain number of years (the number of years will depend upon the findings of this and any previous colonoscopies).
If you have a family history of adenomatous polyps or colorectal cancer, it is good to consider consulting with a gastroenterologist about screening before age 50. If you have a known genetic syndrome that predisposes you to polyps or colorectal cancer, or suspect you may have one, it is very important to maintain a relationship with a gastroenterologist.
Additionally, behavior modifications such as weight loss if obese, or quitting tobacco are personal impacts you can make to lower your own risk of colorectal cancer. Calcium and folic acid might have a protective role if taken in the correct amounts.
Treatment for colorectal cancer depends largely on the stage of the cancer. Treatment options include:
Here is a list of just some of the plans we accept, please contact our office if you have any questions.
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