What is the significance of having a colon polyp?


What is the significance of having a colon polyp?

The finding of a polyp in the colon or large intestine raises several questions. Can they lead to colon cancer and will it require surgery to remove them, are a couple of questions many patients will want answered.

When it comes to colon polyps, there are several different types, some having the potential to become cancerous while others have virtually no chance of developing into colon cancer. It is important to know that polyps are common as they occur in 30 to 50 percent of adults and that not all polyps become cancerous. It can take many years for a polyp with the potential of becoming cancerous to happen and that if a polyp is found during a colonoscopy, they can be completely and safely removed.

When a polyp is found during a colonoscopy, it depends on the number, type, size and location of it as to whether it will be removed right away or if it will require a follow-up visit to do so. Keep in mind that new polyps can develop over time that will also need to be removed.

What causes colon polyps?

For many of us living in industrialized countries, dietary and environmental factors play a role in their development.  Here are some of these factors:

·      Lifestyle – Even though it is not completely understood why polyps develop, lifestyle factors do appear to play a role which include eating a high-fat diet, a diet high in red meat, a low-fiber diet, cigarette smoking, and obesity. 

·      Aging – Before the age of 40, colorectal cancer and polyps are uncommon. Ninety percent of people with polyps are older than age 50, with men more likely to develop polyps than women. That is why colon cancer screening is usually recommended starting at age 50 for both sexes. Small polyps in the colon having the potential to become cancerous, grow very slowly as it takes approximately 10 years for them to develop into cancer. But it is still better to be checked every 10 years after the age of 50 to find and remove them before they become cancerous.

·      Family history and genetics – Polyps and colon cancer tend to run in families.  Any family history of colon polyps or colon cancer should be discussed with a healthcare provider, especially if the cancer was found at an early age. If there is a family history of colon cancer or polyps, generally screening for colon cancer begins at an earlier age.

Types of colon polyps

The most common types of polyps are hyperplastic and adenomatous polyps. There are other types of polyps also found in the colon but they are far less common.

·      Hyperplastic polyps – These polyps are usually small and located in near the last portion of the colon (the rectum and sigmoid colon). This type has no potential to become malignant or causing cancer.  Because they are sometimes hard to distinguish from a adenomatous polyp during a colonoscopy, they are almost always removed or biopsied to determine the exact type of polyp they are.

·      Adenomatous polyps – Up to two-thirds of colon polyps are adenomas. The majority of them do not develop into cancer but they do have the potential to become cancerous. They are classified by their size, general appearance, and the specific features they have when observed under a microscope.  Generally, they larger the adenoma, the more likely it is to eventually become colon cancer.

·      Malignant polyps – Any polyp containing cancerous cells are considered malignant polyps.

A colonoscopy will be the best way to find and evaluate any polyps found in the colon. Doctors performing colonoscopies view the entire lining of the colon and will remove most if not all, polyps found (occasionally large polyps need to be removed during a separate procedure).

How are polyps in the colon removed?

The procedure of removing a polyp is called a polypectomy. This procedure is safe with few risks or complications. The most common complications are bleeding and perforation (creating a hole in the colon) which both are very infrequent.  Small polyps can be removed with an instrument that is inserted through a colonoscope that snips off small pieces of the tissue. Larger polyps are usually removed by placing a noose or snare, around the polyp base and burning it with electric cautery. The cautery also helps stop bleeding after the polyp is removed.

Removal of polyps is not painful; one is because the patient is sedated during the procedure and secondly, the lining of the colon does not have the ability to feel pain.

Lifestyle measures preventing colon polyps

What specifically can one do to help lower their risk of developing colon polyps and potentially colon cancer?  Here are the details of things to do within our control helping dodge a diagnosis of colon cancer:

·      Maintain a healthy body weight

·      Be physically active for at least 30 minutes a day and avoid excessive sitting

·      Avoid smoking

·      Avoid overconsumption  of alcohol – drinking more than 2 or more alcoholic drinks (1.05 ounces) a day linked to a greater risk of colon cancer

·      Eat little to no processed meats such as ham, hot dogs, and bacon

·      Emphasize eating more fruits and vegetables

·      Avoid highly processed grains (white bread, white rice, sugar)

·      Consume at least 25 grams of dietary fiber sources each day

·      Choose low-fat dairy foods

·      Both men and women at average risk should start regular colon cancer screening starting at age 50 and continuing until age 75 years