Colon cancer is the second-deadliest form of cancer in the United States, with an estimated 140,000 plus cases diagnosed in 2019. As of 2018, the American Cancer Society changed its guidelines for a patient’s first colonoscopy screening from age 50 to age 45 for both men and women. Colonoscopy is the gold standard for the detection of both colon cancer and colonic polyps, which are the direct precursor to colon cancer. Read on to learn more about colonic polyps, why you should be concerned about them, and when you should get checked for polyps.
What Are Colonic Polyps?
Colonic polyps are small growths that are found on the surface of the colon. They are also sometimes referred to as colorectal polyps, and these types can be found on both the surface of the colon as well as the rectum. The colon is also known as the large intestine, the organ where stool is both formed and stored. Researchers and doctors are not entirely sure why some patients are predisposed to colonic polyps, while others are not. They don’t know exactly why these growths form. Polyps form when cell division happens at a much more rapid rate than it should, but this is all that is known about colonic polyp growth. It is also important to note that not all colorectal polyps turn into colorectal cancer, but in order to be safe, your physician must remove any colon polyps he or she finds. The likelihood that the polyps may turn into colon cancer is too high.
Most patients don’t experience symptoms from polyps, but it is possible to experience some signs, particularly if the polyps are located on the rectum. Some symptoms of colonic polyps to be mindful of include:
- Blood on toilet paper after wiping
- Blood in the stool
- Pain, constipation, or diarrhea that lasts upward of a week
- Nausea and vomiting
If you experience any of these signs or symptoms, you should be evaluated by a healthcare provider as soon as possible. Rectal bleeding can be a cause of colonic polyps as well as many other gastrointestinal disturbances that require treatment.
Types of Colonic Polyps
There are three types of colonic polyps. Polyps can vary by size and frequency and are divided into three categories:
- Hyperplastic polyps are benign and will not likely develop into cancer.
- Adenomatous polyps may develop into cancer and may not. Your physician will remove this type upon colonoscopy to be sure.
- Malignant polyps are already cancerous, and cancer cells are visible in the polyp.
One of the best features of colonoscopy is: it is one of the few screening tests that can also screen for colon cancer and remove very early stages of it. If your doctor finds malignant polyps that have not yet become colon cancer, they can remove them during the colonoscopy. This is why early screening and detection is so important. Colorectal cancer has a very poor outlook and survival rate if it exceeds beyond stage III.
Who Is at Risk for Colonic Polyps?
Sometimes colonic polyps form when a patient has no risk factors at all. Anyone can be diagnosed with colon polyps. However, there are certain risk factors to be mindful of. While the American Cancer Society has lowered screening guidelines to age 45 for the general public, you may need to be tested sooner if you meet certain conditions. It is wise to learn about your family history. If you have a first-degree relative with a history of colon cancer or colonic polyps, you should be screened before age 45. Other general risk factors include:
- Being overweight or obese
- Having type II diabetes
- Being a smoker
- Being over the age of 50
- Having inflammatory bowel disease (IBD), ulcerative colitis (UC), or Crohn’s disease
- Overconsumption of red meat, particularly in women
While you can change your lifestyle habits, such as being a smoker or eating red meat, there are some genetic conditions you cannot change. In addition to learning about your family history with respect to colon cancer, you should also learn about any first-degree relatives with genetic conditions. If you or any relatives have the following conditions, you are more likely to develop colonic polyps or colon cancer.
- Familial adenomatous polyposis (FAP). This is a condition that can cause hundreds to thousands of polyps to grow and may even be seen as early as adolescence.
- Peutz-Jeghers syndrome. This genetic condition causes freckles to form throughout the body. It can also cause malignant colonic polyps.
- Lynch syndrome. This genetic disorder is directly linked to malignant colon polyps.
- Serrated polyposis syndrome. This disorder causes adenomatous polyps, which are a type that can turn into colorectal cancer.
- Gardner’s syndrome. This is a subtype of FAP that may cause polyps to grow throughout the body, including the colon.
- MYH-associated polyposis (MAP). This is a genetic disorder of the MYH gene, which can cause polyps to form during young adolescence.
If you have any of the above risk factors, particularly genetic disorders, talk to your doctor about early screening.
How Are Colonic Polyps Diagnosed?
Colonoscopy is the gold standard for colon cancer and polyp detection. A colonoscopy requires overnight prep and involves a camera being attached to a long tube that is inserted into the anus. Your healthcare provider can then see any polyps in the rectum and colon, and remove them or take a biopsy. There are other methods for diagnosing polyps, however, that your physician may use. Sigmoidoscopy is similar to colonoscopy but only allows the doctor to see the rectum and lower part of the colon. If polyps are discovered, they cannot be removed with the tool, and a colonoscopy will need to be scheduled.
A barium enema involves an injection of barium into the rectum, followed by an X-ray. Polyps are dark, and therefore show up on X-ray technology. A CT colonography is sometimes referred to as a virtual colonoscopy. While it can’t remove polyps because it is non-invasive, it does give your healthcare provider a good look at your colon and rectum.
Your doctor may also order a stool test, which is a take-home test that tests for microscopic bleeding. This test is used not only to diagnose potential polyps but to screen for other GI disorders.
How Are Colonic Polyps Treated?
Immediate removal is the best way to treat colonic polyps, and this is performed during a colonoscopy. In some cases, larger polyps cannot be removed with the colonoscope, and surgery must be scheduled. Laparoscopic surgery is a fairly non-invasive surgery that uses a laparoscope to remove larger polyps. In most cases, however, colonic polyps are easily removed during a colonoscopy, a procedure known as polypectomy.
If you have any type of colonic polyps, you will need to follow up with your doctor after removal. Hyperplastic polyps require follow-up in roughly 10 years, but adenomatous and malignant polyps require regular follow-up and colonoscopy after removal.
How Can Colonic Polyps Be Prevented?
Colonic polyps can not be directly prevented, as in some cases the causes are genetic, but patients can adopt healthier lifestyles in order to prevent the possibility of polyps and colon cancer. Quitting smoking, limiting alcohol intake, and limiting red meat consumption are good measures to take. Eating a healthy diet, regular exercise, and having a body mass index (BMI) within the normal range are also good ways to prevent polyps. If you need more information about colonic polyps or colon cancer or wish to schedule a screening for a colonoscopy, request an appointment with Cary Gastroenterology today. We have two offices, several endoscopy centers, and a women’s health center to meet all of your GI needs.