Colon polyps and their role in colon cancer
You had a colonoscopy to test for colon cancer and were told that polyps had to be removed. What does that mean? Is it a sign of something serious? Will those polyps come back? Gastroenterologist Veeral M. Oza, MD, answered common questions he receives from his patients about colon polyps and colon cancer.
What are colon polyps?
Colon polyps are growths in the colon or the large intestine that occur over time.
“Our bodies are involved in making subtle, microscopic, molecular level repairs on a second-to-second basis,” Dr. Oza explained. “There are mechanisms in place that prevent a normal cell from continuing to divide or repair itself. When you have a mutation in one of these genes, where the checkpoints are no longer functioning effectively and it doesn’t tell the cell to stop dividing, it can lead to growths called colon polyps.”
Left alone, these polyps can turn into cancer.
“Most colon polyps occur after the age of 45 to 50, but we are seeing younger and younger patients that have these growths,” he said.
How long does it take a colon polyp to turn into cancer?
The progression from polyp to cancer can be anywhere from seven to 10 years – or faster if you have a genetic predisposition to having colon cancer.
Colon polyps have no symptoms, which is why doing a colonoscopy or screening for colon cancer becomes important, particularly after age 45. Those with a genetic predisposition might need a colon cancer screening sooner.
What percentage of colon polyps turn into cancer?
“That really depends on the type of polyp you have,” Dr. Oza said.
There are multiple types of colon polyps. The most common one found in a colonoscopy is called adenoma, which literally means a benign growth. But in this case, it’s a growth that can lead to cancer.
“The percentage of colon polyps that develop colon cancer is not very high. However, there’s no way for us to predict which adenomatous polyp will turn into cancer and which adenomatous polyps will not. So, our rule of thumb is to take all the polyps out,” Dr. Oza said.
How are colon polyps removed?
Tools are used that go through a camera’s scope to remove small growths. Either a forceps or a snare that goes around the polyp and shaves it off from the base of the surface of the colon can be used.
“If the polyp is larger, we might have to lift them off the surface, making it safe for us to cut it,” Dr. Oza said. “We sometimes use electrocautery, or heat energy, to cut through these polyps. Most polyps, and in some cases even early forms of colon cancer, can be removed with a colonoscopy and it is extremely rare to require surgery for removing a non-cancerous growth.
If the polyp is very large and not conducive to removal with a colonoscopy, we will refer the patient to a surgeon. But over 90 to 95% of polyps that we find are removable by colonoscopy.”
After they’re removed, what are the chances the polyps can return?
That depends on the genetics of an individual and whether the polyp was removed entirely or if anything was left behind.
“We have things that we do during the procedure to make sure that everything is completely gone,” Dr. Oza said.
Depending on the size of the polyp and how it was removed, a patient may need a repeat colonoscopy in three to six months to make sure it hasn’t regrown at the same spot.
“Most of the time that does not happen. Once removed safely and completely, polyps do not tend to grow back. You might have another polyp in another location in the intestines, but not in the same spot,” he said.
Is there anything you can do to prevent colon polyps?
Colon polyps may not be entirely preventable. However, there are things you can do to make sure your risk of developing polyps remains as low as possible, such as:
- Eat healthy and live a healthy lifestyle
- Avoid smoking and using tobacco
- Exercise regularly
“We cannot change our genetics, but we can certainly do things which allow us to reduce our risk for colon cancer,” Dr. Oza said. “Please encourage your friends and family members to get their screening colonoscopies at age 45.”
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