My Colonoscopy shows polyps, now what?

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After undergoing a scheduled screening colonoscopy at the age of 45, you come to know that something called a polyp was found and taken out during the procedure. In such scenarios, I often have patients coming in with these questions: What is a polyp? Is it cancerous? If not, then why did you have to snip it off? 

Finding a polyp during a colonoscopy might sound alarming. With that said, the good news is most of the polyps are benign, meaning they aren’t cancerous. But because a small percentage of polyps can become cancerous, I prefer to remove any colon polyps you have.

What are Colon Polyps?

Polyps are small outgrowths that project from your colon’s inner lining into its hollow space (called lumen). The two most common kinds of polyps are:

  • Hyperplastic polyps. If your pathology report mentions these polyps, you were likely born under a lucky star. These polyps virtually don’t evolve into cancer. But they’re still snipped off to be on the safe side. 

  • Adenomas. These are gland-like growths on the lining of your colon. Not all adenomas are harmful. However, given the fact that more than 95% of colon cancers begin as adenomas, these polyps need to be taken out and tested for any cancerous changes. The adenomas can grow in several patterns such as: 

    • Tubular: tube-like

    • Villous: finger or tube-like (carries the highest potential to become cancerous)

    • Sessile: flat polyps

    • Pedunculated: with a stalk

    • Serrated: saw-tooth like appearance

How long does it take for a Polyp to turn into Cancer? 

Thankfully, the series of events that drive the conversion of adenoma to cancer occur at a very slow pace. Hence, most of the polyps take about 10 years to progress into cancer, if at all. We all have genes that prevent the tumor cells from being activated. A mutation (alteration) of these genes in one of the parent (stem) cells that line your colon is what triggers the adenoma-to-cancer transformation. These stem cells are continually dividing to generate cells at a faster rate. And as additional cells divide, they pick up even more mutations, thus raising your risk of colon cancer. 

When do I need to follow-up?

About 30% of polyps in the colon have a tendency to rear their heads again despite complete removal of the existing ones. This is especially true if the polyp removed was an adenoma (as per your biopsy report). Hence, you’ll need to have a follow-up colonoscopy in 5 years to ensure that no more adenomas are beginning to grow again. 

The timing of the next colonoscopy depends on the results of your first colonoscopy, such as:

  • the number of polyps removed 

  • the type and size of the polyp

  • the presence of any high-grade precancerous (abnormal) changes

In general, the more adenomas you have and the larger they are, the higher their risk of turning into cancer. Having any abnormal changes on top of that further amplifies the cancer risk.

If you have any questions regarding your last colonoscopy, or if you’d like to schedule an appointment for a repeat colonoscopy, you can contact my office at 310-360-6807. Alternatively, you may book an appointment online by clicking below.