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Colon polyps are growths in your
large intestine (colon). The cause of most colon polyps is not known, but they
are common in adults.
Over time, some polyps can turn into colon cancer. It usually takes many years for that to happen.
You can have colon polyps
and not know it, because they usually don't cause symptoms. They are usually
found during routine screening tests for colon cancer. A screening test looks
for signs of a disease when there are no symptoms.
If polyps get
large, they can cause symptoms. You may have bleeding from your rectum or a
change in your bowel habits. A change in bowel habits includes diarrhea,
constipation, going to the bathroom more often or less often than usual, or a
change in the way your stool looks.
Most polyps are
found during tests for colon cancer. Experts recommend routine colon cancer
testing for everyone between the ages of 50 and 75 who has a normal risk for colon cancer.
People with a higher risk, such as those with a strong
family history of colon cancer, may need to be tested sooner. The tests for colon
Doctors often recommend colonoscopy, because it lets them
look at the whole colon and remove any polyps they find. If polyps are found
during another type of test, you may still need colonoscopy so the doctor can
remove the polyps.
You are more likely to have colon polyps if:
Doctors usually remove colon
polyps, because some of them can turn into colon cancer. Most polyps are removed
during a colonoscopy. You may need to have surgery if you have a large
After you have had polyps, you have a higher chance of developing new polyps. If you have had polyps removed,
it is important to have follow-up testing to look for more polyps. Talk to your
doctor about how often you need to be tested.
Learning about colon polyps:
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Colon polyps usually do not cause
symptoms unless they are larger than
1 cm (0.4 in.) or they are
cancerous. The most common symptom is rectal bleeding. Sometimes the bleeding
may not be obvious (occult) and may only be discovered after doing a screening
test for blood in the stool called a
fecal occult blood test (FOBT).
polyps usually do not cause pain or a change in bowel habits unless they are
large and are blocking part of the colon. These symptoms are rare, because
polyps usually are discovered and removed before they become large enough to
After cancer develops, additional symptoms may
occur, such as changes in bowel habits and significant weight loss.
colon polyps are large and cause bleeding or pain, the
only way to know if you have polyps is to have one or more tests that explore
the inside surface of your colon.
Several tests can be used to
detect colon polyps. Two of these exams,
flexible sigmoidoscopy and
colonoscopy, also can be used to collect tissue
samples (called a
biopsy) or to remove colon polyps. All the tests may
be used to screen for colon polyps and colon cancer and as follow-up tests
after colon polyps have been removed. There are two basic types of tests—stool
tests and tests that look inside your body.
Screening for colon
cancer with a single test or a combination of tests reduces your chance of
having complications and dying from colon cancer.
Experts recommend routine colon cancer testing for everyone between the ages of 50 and 75 who has a normal risk for colon cancer. People with a
higher risk, such as those with a strong family history
of colon cancer, may need to be tested sooner. Talk to your doctor about when you
should be tested.
If you are between the ages of 50 and 75, screening may lower
your risk of dying from colon cancer. Screening options include the following
The method of screening that you have depends on your
personal preferences, your doctor's preferences, and what the clinic or office
you go to is able to do.
People with a
higher risk for colon cancer, such as those with a strong family history of colon cancer, may need to be tested sooner. Talk to your doctor about when you should be tested.
If you have a family history of
familial adenomatous polyposis (FAP), you should start screening tests at age 10 or 12.
If you have a family
hereditary nonpolyposis colon cancer (HNPCC), you
should have a colonoscopy every 1 to 2 years starting at age 20 to 25, or 10
years younger than the age at which the youngest family member who has
colorectal cancer was diagnosed, whichever comes first.
Talk with your doctor. Decide with him or her when to start and stop screening for colon cancer. These decisions will depend on how old you are, your
family history, any health problems you have, and the benefits you can
expect from regular screening.
biopsy of polyps obtained during screening reveals
hyperplastic polyps of any size, routine follow-up
screening is all that is needed. These polyps do not become cancerous.
Most doctors agree that if you have had one or more
adenomatous polyps removed, you probably need regular
follow-up colonoscopy exams every few years. This type of polyp is more likely
to turn into cancer, but that risk is still very low. How often you need a
colonoscopy may depend on the number and size of the polyps, your age, your
health, and other risk factors that you may have for polyps. Talk with your
doctor about the follow-up testing schedule that is right for you.
Polyps are removed during screening if you have a
flexible sigmoidoscopy or
colonoscopy. The polyp is examined to find out if it
is the kind that could become cancer.
adenomatous polyps are found during an exam with
flexible sigmoidoscopy, a colonoscopy will be done to look for and remove any
polyps in the rest of the colon.
The bigger a
colon polyp is, especially if it is larger than
1 cm (0.4 in.), the more likely
it is that the polyp will be adenomatous or contain cancer cells.
hyperplastic polyps are found during your flexible
sigmoidoscopy, you likely do not need to have a colonoscopy. These polyps do
not become cancerous. In this case you can continue your regular screenings,
unless you are at an
increased risk for colon cancer because of a family
history of colon cancer or an inherited polyp syndrome.
A sessile polyp doesn't have a stalk. It is mostly a flat growth. Like other colon polyps, it grows on the inside wall of the colon. Sessile polyps can turn into cancer. Like other polyps, they are removed if found during sigmoidoscopy or colonoscopy.
Complications from colonoscopy are rare. There is a slight risk
Regular screenings for
colon polyps are the best way to prevent polyps from
developing into colon cancer.
Most colon polyps can be identified and removed during a
If you have had one or more adenomatous polyps
removed, you probably need regular follow-up colonoscopy exams every 3 to 5
years. Talk with your doctor about the follow-up schedule that he or she thinks
is best for you.
sometimes needed for large
colon polyps that have a broad area of attachment
(sessile polyps) to the colon wall. These large polyps sometimes cannot be
removed safely during a colonoscopy and may be more likely to develop into
If cancer is found when the colon polyps are examined, you
will begin treatment for
colorectal cancer. For more information, see the topic
No home treatment is done for
colon polyps. See Treatment Overview for more information.
But you can take action that may
prevent colon polyps:
Experts are not yet certain that these approaches prevent
colon polyps or
methods should not be a substitute for regular colorectal screening, especially
if you are older than 50 or are at
increased risk for colon polyps or colon cancer. While
these approaches may decrease your risk for colon polyps, they will not prevent
you from ever having colon polyps.
The American Cancer Society (ACS) conducts educational
programs and offers many services to people with cancer and to their families.
Staff at the toll-free number have information about services and activities
in local areas and can provide referrals to local ACS divisions.
The American College of Gastroenterology is an organization of digestive disease specialists. The website contains information about common gastrointestinal problems.
The American Society of Colon and Rectal Surgeons is the leading
professional society representing more than 1,000 board-certified colon and
rectal surgeons and other surgeons dedicated to treating people with diseases
and disorders affecting the colon, rectum, and anus.
This clearinghouse is a service of the U.S. National
Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the
U.S. National Institutes of Health. The clearinghouse answers questions;
develops, reviews, and sends out publications; and coordinates information
resources about digestive diseases. Publications produced by the clearinghouse
are reviewed carefully for scientific accuracy, content, and readability.
Other Works Consulted
Bresalier RS (2010). Colorectal cancer. In M Feldman et al., eds. Sleisenger and Fordtran’s Gastrointestinal and Liver Disease, 9th ed., vol. 2, pp. 2191–2238. Philadelphia: Saunders.
Lieberman DA, et al. (2012). Guidelines for colonoscopy surveillance after screening and
polypectomy: A consensus update by the U.S. Multi-Society Task Force
on Colorectal Cancer. Gastroenterology, 143(3): 844–857.
Rex DK, et al. (2009). American College of
Gastroenterology guidelines for colorectal cancer screening 2008.
American Journal of Gastroenterology, 104(3):
Syngal S, Katrinos F (2012). Colorectal cancer screening. In NJ Greenberger et al., eds., Current Diagnosis and Therapy: Gastroenterology, Hepatology, and Endoscopy, 2nd ed., pp. 273–286. New York: McGraw-Hill.
U.S. Preventive Services Task Force (2008). Screening for colorectal cancer: U.S. Preventive Services Task Force recommendation statement. Available online: http://www.uspreventiveservicestaskforce.org/uspstf/uspscolo.htm.
August 20, 2013
E. Gregory Thompson, MD - Internal Medicine & Jerome B. Simon, MD, FRCPC, FACP - Gastroenterology
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