Monday, May 9, 2011

Colon Polyps

Colon cancer is one of the leading causes of death for both men and women. For the most part, death is avoidable with by using the very good screening tool we have called the colonoscopy. The colonoscopy is a procedure where a probe is inserted into the colon (commonly known as the large bowel)  which allows the physician to view inside the colon for abnormalities as well as take samples of these to determine what the nature of these abnormalities are.  This blog is about an announcing growth that needs investigation referred to as a precursor growth in the colon called the polyp.

                  Normal Colon                              Colon polyps

There are all different types of colon polyps, some pre-cancerous and some not. The most common polyps seen are called non-neoplastic polyps which include those called hyperplastic.  Even though hyperplastic polyps are benign (or noncancerous), consideration must be given to their appearance, such as some (serrated forms) may have the potential for cancer.  As well, there are some hyperplastic polyps which occur in large numbers together; a syndrome called Hyperplastic polyposis syndrome. This syndrome requires more intense screening due to increased risk of cancer development.

There are other polyps associated with other conditions such as Crohn’s disease or inflammatory bowel disease (IBS) which are both other diseases of the bowels. These types of polyps typically occur in multiples and need to followed closely by a physician.

Another important category of colon polyps are adenomatous polyps. These are by definition pre-cancerous. Nearly all colorectal cancers arise from adenomas, but only a small minority of adenomas actually progress to cancer( about 5 %). Risk factors for getting this type of polyp include older age( starts at age 50), obesity, and being a man. Adenomas can go through a process from low grade to high grade to cancer, or can present as high grade. You just don’t know where it is without looking under the microscope!

Adenomas have different shapes.  Tubular adenomas account for about 80% of colon adenomas. Another type of adenoma is called villous adenoma. These polyps grow at variable rates, thus, when to repeat colonoscopy is based on size of the polyp. Adenomatous polyps bigger than 1 cm are a risk factor for containing cancer. If the adenomatous polyp is has a villous pathology( fingerlike under the microscope), the risk one whether one will develop cancer is also based on size( more than 1 cm, risk is up to 30% for that polyp to develop cancer).

So, it is very important to get screened for colon cancer. How often and when to begin depend on multiple factors including family history. This is a good topic to discuss with your doctor. There are some factors to prevent colorectal adenomatous polyps have been studied: diet—low in fat, high in fruits and vegetables as well as fiber. Maintaining normal body weight, regular exercise, dietary calcium intake, and avoidance of tobacco and excessive alcohol intake, especially beer are recommended.


Dr. Frank Marinkovich owns and operates Eastside Family Health Center in Kirkland, WA. Serving Kirkland and the Eastside, Seattle, Bellevue, Renton and the surrounding local communities. Specializing in Primary Care, Automobile Accidents and FAA physicals. Visit them online at Eastside Family Health Center or call them at (425) 899-2525.
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  1. This was very informative. Thank you for posting this.

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