Colon Polyps (cont.)
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What other types of polyps are there in addition to adenomas?
Although adenomas are by far the most common type of colon
polyps, there are several other types of polyps. Among the other
types of polyps that have no malignant potential are the
hyperplastic, inflammatory, and hamartomatous polyps.
What are the guidelines for screening individuals for polyps
in order to prevent colon cancer?
Knowing that colon polyps grow and go on to become cancerous and
knowing how common they are, screening guidelines have been set by
the American Cancer Society to minimize the risk of colon cancer by
detecting and removing polyps.
Starting at the age of 40, everyone should have a stool specimen
tested for occult blood (blood that cannot be seen with the naked
eye) every year. This is recommended because it is known that when
polyps become large they can bleed into the intestine where the blood
mixes with the stool. Thus, an early warning sign for colon polyps
could be the presence of occult blood in the stool.
Starting at the age of 50, everyone should have a flexible
sigmoidoscopy every 3-5 years. A flexible sigmoidoscope is a two and
one-half foot tube half an inch in diameter with a light on the end
that can be inserted through the anus for inspecting the inside of
approximately one-third of the colon's total length.
If adenomatous polyps are detected with sigmoidoscopy, then a full
colonoscopy with a longer tube (four to five feet) should be used to
inspect the entire length of the colon. During a colonoscopy, any
polyp can be removed and sent for an evaluation under the microscope
to determine if it too is an adenomatous polyp.
Many doctors in the US are recommending screening colonoscopies rather than
flexible sigmoidoscopies for healthy subjects with an average risk for
developing colon cancer. Colonoscopies are recommended beginning at the age of
50 and thereafter every 7-10 years if no colon polyps or cancers are found. The
rationale for this recommendation is: 1) Colonoscopy examines the entire colon
while flexible sigmoidoscopy only examines the rectum and the colon adjacent to
the rectum, 2) approximately 50% of colon polyps (and colon cancers) are found
in the upper colon (cecum, ascending colon, and transverse colon) and,
therefore, are beyond the reach of sigmoidoscopes and would be missed by
flexible sigmoidoscopy, and 3) the National Polyp Study, a large, scientific
study, has shown that colonoscopy with removal of all colon polyps reduces
deaths from colon cancer.
Next: What kind of additional surveillance should be done once a polyp has been found? »
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