A colon polyp is a growth which occurs on the lining of the colon. The colon is hollow and the inner surface is generally smooth. Some individuals grow polyps, or small lumps of tissue, on the inner wall of the colon. The reason for this is still unknown, but the incidence of polyps generally increases with age.

What does a polyp look like?

Colon polyps can be several shapes. Polyps on stems or stalks look like mushrooms and are called pendunculated. When they grow directly onto the inner wall of the colon, like pimples, they are called sessile. Some polyps are flat, making them much more difficult to remove.

Why remove polyps if they are benign?

Colon polyps are important since some may turn into colon cancer over time. While not every colon polyp turns to cancer, almost every colon cancer begins as a small non-cancerous polyp. Fortunately, during a colonoscopy, these polyps can be identified and removed or destroyed, thus preventing possible colon cancer. Once the polyps are removed, the tissue is sent to a pathologist to determine the exact type.

What are the types of colon polyps?

There are basically four types of polyps that commonly occur within the colon.

1. Inflammatory -These polyps are most often found in patients with ulcerative colitis or Crohn’s disease. Often called pseudopolyps, they are not true polyps, but just a reaction to chronic inflammation of the colon wall. They are not the type that become cancerous.
2. Hyperplastic -This is a common type of polyp which is usually considered to be low risk for cancer.
3. Tubular adenoma or adenomatous polyp -This is the most common type of polyp and the one referred to most often when a doctor speaks of colon polyps. About seventy percent of polyps removed are of this type. Adenomas carry a definite cancer risk which rises as the polyp grows larger. Adenomatous polyps usually cause no symptoms, and if detected early they can be removed during colonoscopy before any cancer cells form. Polyps generally grow slowly and may take years to turn into cancer. Patients who grow adenomatous polyps must have periodic colonoscopies to remove them before they become cancerous.
4. Villous adenoma or tubulovillous adenoma -About fifteen percent of polyps removed are of this type. This is a much more serious type of polyp that has a very high cancer risk as it grows larger. Often they are larger and sessile, making removal more difficult. Smaller ones can be removed in piecemeal fashion, sometimes over several colonoscopies. Larger sessile villous adenomas may require surgery for complete removal. Follow up depends on size and completeness of removal.

Can I reduce my risk of colon polyps?

Although there are several risk factors thought to contribute to the formation of polyps, there is no reliable way to prevent colon polyps. Periodic colonoscopy exams are recommended.

How can I reduce my risk of colon cancer?

The answer is colonoscopy, colonoscopy, colonoscopy. If you have had polyps in the past, you have about a sixty percent chance of growing more polyps in the future. There are usually no warning signs to indicate the presence of colon polyps. With periodic colonoscopy exams, you can maximize your chances that any new polyp will be detected and removed before cancer cells develop. Rarely, a colon cancer may develop between exams. Fortunately, they are usually small and can be treated surgically. Periodic colonoscopy can significantly reduce your risk of colon cancer.

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