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February 8, 2012

Colon Polyps

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What is a colon polyp?

Colon polyps are fleshy growths that occur on the inside (the lining) of the large intestine, also known as the colon. Polyps in the colon are extremely common, and their incidence increases as individuals get older. It is estimated that 50% of the people over the age of 60 will harbor at least one polyp. The significance of polyps is that we know that when certain types of polyps grow large enough, they can become cancerous, and, moreover, colon cancer is the second leading cause of death from cancer in the United Sates. Therefore, screening for colon polyps and removing them before they become cancerous should markedly reduce the incidence of colon cancer.

What types of polyps become cancerous?

The polyps that become cancerous are called adenomatous polyps or adenomas. Adenomas account for approximately 75% of all colon polyps. There are several subtypes of adenoma that differ primarily in the way the cells of the polyp are assembled when they are examined under the microscope. Thus, there are tubular, villous, or tubulo-villous adenomas. Villous adenomas are the most likely to become cancerous, and tubular adenomas are the least likely.

Are there other factors that determine a polyp's chance of becoming cancerous?

Another factor that contributes to a polyp's likelihood of becoming cancerous is its size. The larger a polyp grows, the more likely it is to become cancerous. Once a polyp reaches two centimeters or approximately one inch in size, the risk of cancer is in excess of 20 percent. Therefore, it is advisable to remove polyps of any size, preferably when they are of a small size, to prevent their growth and progression to cancer.



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Colon Polyps

What is a fecal occult blood test?

Fecal occult blood testing (FOBT) is testing that is performed on samples of stool in order to detect occult blood (blood that is not visible to the naked eye) in otherwise normal-colored stool. Fecal occult blood usually is a result of slow (often intermittent) bleeding from inside the upper or lower gastrointestinal tract. The slow bleed does not change the color of the stool or result in visible bright red blood, and hence the blood is found only by testing the stool for blood in the laboratory. Occult bleeding has many of the same causes as other forms of more rapid gastrointestinal bleeding such as rectal bleeding (passage of red blood and/or blood clots rectally) and melena (black tarry stool as a result of bleeding from the upper intestines such as ulcers). Please read the Rectal Bleeding article for a more detailed explanation of different patterns of gastrointestinal bleeding.

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