1/03/2009

Are Colorectal Polyps Cancerous?

If not sooner, people above 50 should start taking greater care for their health: not just curative, but also preventive. This is not an old age, but is an age when people are more exposed to potential diseases. In this article we will discus colorectal polyps and whether they are cancerous or not. ...
If not sooner, people above 50 should start taking greater care for their health: not just curative, but also preventive. This is not an old age, but is an age when people are more exposed to potential diseases.
In this article we will discus colorectal polyps and whether they are cancerous or not. Regular screenings for colon polyps are the best way to prevent polyps from developing into colon cancer. All men and women ages 50 and older should have a fecal blood test every year, a flexible sigmoidoscopy every 5 years, or even both.

What are polyps?



Polyps are abnormal growths rising from the lining of the large intestine (colon) and protruding into the intestinal canal (lumen). They are one of the most common conditions affecting the colon and rectum and are found in about nine of every 10,000 persons.
Polyps are usually classified into two types: adenomatous polyps (adenomas) and hyperplastic polyps.
Most polyps are noncancerous and cause no symptoms. They are called hyperplastic polyps.
Adenomas are the precursor lesions for colorectal carcinoma (colon cancer). The more common hyperplastic polyps are benign and, in most circumstances, are not considered to be pre-malignant.





A colorectal polyp is a growth that sticks out of the lining of the colon or rectum. Polyps are grape-like growths on the lining of the colon and rectum, they can be single or multiple and do become more common in people over age 50.





Usually colorectal polyps are benign, but slowly over the years they can develop into cancer, although not causing any symptoms.
Colorectal polyps are most of the time benign (not cancerous), but may cause painless rectal bleeding.
Below we will discus types of colorectal polyps that have or don't have the tendency to become cancerous.

Polyps may be (besides age and family history) also associated with some hereditary disorders:




  • Gardner's syndrome


  • Peutz-Jeghers syndrome


  • Lynch syndrome (HNPCC)


  • Juvenile polyposis


  • Familial adenomatous polyposis





Symptoms of Colorectal Polyps

Usually there is no symptoms; however, following symptoms might occur:




  • bleeding from rectum


  • bloody stool or any unusual changes in routine bowel movements


  • abdominal pain


  • fatigue and anemia


  • unexplained weight loss





Are Colorectal Polyps cancerous or not?

Most types of polyps, also called hyperplastic polyps do not have a tendency to develop into cancer. However, over time, certain types of polyps, also called adenomatous polyps, may develop into cancer. Also, polyps greater than one centimeter have a greater cancer risk associated with them than polyps under one centimeter. Risk factors include advancing age (over age 50) or a family history of colon cancer or polyps.

Hyperplastic Polyps and Treatment Options

If only hyperplastic polyps are found during your flexible sigmoidoscopy, you usually do not need to have a colonoscopy.
In some cases of very small polyps (5 mm or less) they may not be removed. Namely, some studies have concluded that even if they contain adenomatous tissue, these polyps take so many years to grow that they pose little risk of cancer. This is an exception in people who have inherited polyp syndromes. In their case polyp is removed.

Adenomatous Polyps and Treatment Options

Studies were made and they revealed that cigarette smoking has been associated with adenomatous polyps of the large bowel, but not also with increased risk of colorectal cancer.
Adenomatous polyps (adenomas) of the colon and rectum are benign (non-cancerous) growths that have the potential to develop in colorectal cancer- they are pre-malignant. Thus, colorectal adenomatous polyps (adenomas) can develop into cancer and they should be removed. They are larger than one centimeter and are associated with a greater risk of cancer. If they aren't removed, they continue to grow and eventually become cancerous.
In most cases, the polyps may be removed at the same time a colonoscopy is performed. In more rare cases, polyps with a high potential of becoming cancerous, a colectomy (removal of a part of the colon) may be recommended.
As mentioned previous in article, the chance of having polyps is increased in patients with a family history of colorectal polyps or colorectal cancer. That also includes familial adenomatous polyposis or inherited disorders such as Gardner%26rsquo;s syndrome. Adenomatous polyps cause few, symptoms of which painless rectal bleeding is most common. These polyps start out as small nodules on a bowl wall (about the size of a match head) and are almost never malignant at this size, but as they grow they may develop a stalk and look like a small mushroom. In most cases These adenoma polyps must be removed.
Most larger polyps are adenomatous, nevertheless this must be determined by tissue examination, also called biopsy. If during an exam with flexible sigmoidoscopy adenomatous polyps are found, colonoscopy is done to look for and remove any polyps in the rest of the colon.
Of course only physician can determine the type of treatment. We will discuss only possible options.
Colonoscopy is relatively painless and easy way to remove most polyps. Colonoscopy is internal examination of the colon and rectum, and is an outpatient procedure that is performed in physician%26rsquo;s office or a surgical suite. Colonoscopy allows the physician to view the polyp(s) in question and remove it via biopsy.
Complications from colonoscopy are rare, but are possible. There is a slight risk of:




  • Puncturing the colon or causing severe bleeding by damaging the wall of the colon


  • Bleeding caused by removing a polyp.


  • Complications from sedatives given during the procedure.




Additional colonoscopies are almost always necessary to monitor healing and ensure that new polyps have not developed. For patients with polyps, follow-up colonoscopy should be performed within 3 to 5 years to see if the polyps have returned.
For larger colon polyps that have a broad area of attachment to the colon wall surgery is needed. These large polyps often cannot be removed safely during a colonoscopy and may be more likely to develop into cancer.

In conclusion

Regular screenings for colon polyps are the best way to prevent polyps from developing into colon cancer. All men and women ages 50 and older should have a fecal occult blood test every year, a flexible sigmoidoscopy every 5 years, or both. However, if you have had one or more adenomatous polyps removed, you probably need regular follow-up colonoscopy exams every few years.