Colon Polyps (cont.)
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What kind of additional surveillance should be done once a
polyp has been found?
Surveillance after polyps are found depends on the number and type
of polyp that are found. If the polyp is not an adenoma, then follow-
up with colonoscopy is not necessary. If only one polyp is found and
it is a tubular adenoma less than 1 centimeter in size, then
repeating the colonoscopy after five years is appropriate (Unless the
individual has had a first degree relative with colon cancer in which
case three years would be appropriate.)
If a first or subsequent colonoscopy finds three or more adenomas,
the next colonoscopy should be between one and three years later. If
a polyp is flat (sessile) and, therefore, is more difficult to remove
completely, then the site of the removal should be checked in 3-6
months to document complete removal and then again one year later.
Once a normal colonoscopy without polyps is performed, the
surveillance interval can be increased to five years.
What happens if a polyp that is removed contains cancer?
These polyps may be treated without surgical removal of that part
of the colon that contained the polyp if: 1) the doctor is confident
that the polyp was removed completely, 2) the pathologist does not
see any cancer at the margin of the polyp that was attached to the
colon (which would suggest that cancer was left behind), and 3) the
cancer is histologically (under the microscope) "less aggressive"
looking.
Is one's risk of having colon cancer increased by having had
an adenoma?
An individual's risk of colon cancer is approximately double the
general population once an adenomatous polyp is found. This
individual's risk of developing colon cancer can be significantly
reduced by removing the polyp and any future polyps.
Next: What is one's risk of having a polyp or cancer if a first-degree relative (parent, sibling, or child) has had an adenomatous polyp? »
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