Polyps are abnormal growths of the lining of the colon and rectum. They may be flat or mushroom-shaped. They develop as a result of gene errors when colorectal mucosal cells grow. Up to 30% of the adult U.S. population will develop colon or rectal polyps. A well-defined relationship exists between the development of colorectal polyps and colorectal cancer. Essentially, patients with colon or rectal polyps are at increased risk for colorectal cancer.
Most polyps do not cause any symptoms. They are usually small, benign lesions found incidentally on colonoscopy or barium enema. Larger polyps can cause bleeding, mucous discharge, a change in bowel function, or even abdominal pain. Polyps are easily treated with outpatient colonoscopy when they are small; however larger polyps often require colon surgery.
Routine colorectal evaluation is recommended for all adults starting at age 50 to evaluate for the presence of polyps. Patients with a family history of colorectal tumors or symptoms such as bleeding or pain will often be evaluated at younger ages. If colonoscopy is used, polyps that are detected can be destroyed or completely removed at the time of evaluation. Other options for colon polyp detection are sigmoidoscopy and barium enema.
Patients who undergo colorectal screening according to current recommendations reduce their risk of dying from colorectal cancer by about 80-90%. This achievement is due to colonoscopy detecting polyps and removing polyps before cancer can develop. Patients who are found to have polyps will be followed more closely, as they have a higher risk of future polyps.
Some medications are being evaluated to help prevent future polyp development in patients who have been found to have polyps in the past. However, regular checks with a colonoscopy are the best way to prevent polyps from becoming serious and growing into colon cancers.