Colon Polyps

Colon polyps are small growths that form on the inner lining of the large intestine (colon). Many of these growths are completely harmless. However, some can change over time and become cancerous. Colon cancer, if not found early, can be life-threatening.

Anyone can get colon polyps. But some people are more likely to develop them. These include people age 50 and older, those who are overweight, and smokers. A family or personal history of colon polyps or colon cancer also increases your risk.

Often, colon polyps don't cause any noticeable problems. This is why regular checkups are crucial. Catching colon polyps early means they can usually be safely and completely removed. Regular screening and removal of polyps are the best ways to prevent colon cancer.

Many people with colon polyps don't experience any noticeable symptoms. This means you might not realize you have one until a doctor finds it during a routine colon exam. However, some people do have symptoms.

Possible Symptoms:

• Changes in bowel habits: Having trouble going to the bathroom, like constipation or diarrhea that lasts more than a week, could be a sign of a larger polyp or even cancer. But many other things can cause these changes too, such as stress, diet changes, or certain medications.

• Changes in stool color: Blood in your stool might show up as red streaks or make your stool look black. However, food, medications, or supplements can also change stool color.

• Iron deficiency anemia: Bleeding from a polyp can happen slowly over time without you seeing blood in your stool. This ongoing bleeding can lead to a shortage of iron in your blood (iron deficiency anemia). Symptoms of iron deficiency anemia include feeling tired and short of breath.

• Pain: A large polyp can sometimes block part of your bowel, causing cramping or abdominal pain.

• Rectal bleeding: Blood in your rectum could be a sign of a polyp, cancer, hemorrhoids (swollen veins in the rectum), or small tears in the anus.

When to See a Doctor:

If you experience any of the following, it's important to see your doctor:

• Abdominal pain
• Blood in your stool
• Changes in bowel habits lasting more than a week

When Should You Get Screened for Polyps?

Regular colon polyp screenings are recommended for:

• People age 50 and older: This is a general guideline. Some people may need to start earlier than age 50.
• People with risk factors: If you have a family history of colon cancer or other risk factors, your doctor may recommend starting screenings earlier. This is because people with these risk factors are more likely to develop polyps and may need to be screened more frequently.

It's essential to talk to your doctor about your individual risk factors and when you should start getting screened for colon polyps.

See a doctor if you have any of these issues:

• Stomach ache: If you have pain in your belly, it's important to see a doctor.
• Blood in your poop: Finding blood in your stool is a sign that something might be wrong. This could be a serious issue, so it needs to be checked out.
• Changes in bowel movements: If your bowel habits change significantly and last for more than a week, this needs attention. This could include changes like having diarrhea more often, constipation, or a change in how often you have a bowel movement.

Get regular colon screenings if:

• You're 50 or older: Regular screenings for colon polyps are recommended for everyone who reaches the age of 50. Polyps are small growths in the colon, and some can turn into cancer. Catching them early is key.
• You have a higher risk: If you have a family history of colon cancer, or other risk factors, you may need to start getting screened earlier than age 50. Things like a personal history of inflammatory bowel disease (like Crohn's or ulcerative colitis) or certain genetic conditions can increase your risk. Your doctor can help you determine if and when you should start regular screenings.

Normal cells grow and divide in a controlled way. Sometimes, changes in certain instructions within the cells (genes) cause them to keep dividing, even when more cells aren't needed. In the large intestine (colon and rectum), this uncontrolled cell growth can lead to the formation of small growths called polyps. These polyps can develop anywhere along the large intestine.

Polyps are broadly categorized into two types: non-cancerous and cancerous. Non-cancerous polyps usually don't turn into cancer. Cancerous polyps are further divided into two main types: adenomas and serrated polyps. Adenomas are the kind of polyp that most often develops into cancer over time if they aren't removed. Serrated polyps may also become cancerous, but this depends on factors like their size and where they are located in the intestine. Generally, the larger the cancerous polyp, the higher the risk of it becoming cancerous.

Several factors can increase your risk of developing colon polyps or cancer. Understanding these risks is crucial for early detection and prevention.

Age: Most people who develop colon polyps are 50 years of age or older. As you get older, your risk increases.

Health Conditions: Having inflammatory bowel diseases like ulcerative colitis or Crohn's disease in the colon can raise your overall risk of colon cancer. However, the polyps themselves aren't typically a major concern in these cases.

Family History: If a parent, sibling, or child has had colon polyps or cancer, you're more likely to develop them too. The more family members affected, the greater your risk. Sometimes, this increased risk isn't directly inherited but rather due to shared lifestyle factors or environmental influences within a family.

Lifestyle Choices: Smoking and heavy alcohol use (three or more drinks per day) are linked to a higher risk of colon polyps. Combining these habits appears to increase the risk even further. A lack of exercise, being overweight, and a diet high in unhealthy fats can also contribute to a higher risk.

Race: Black Americans have a slightly higher risk of developing colon cancer.

Genetic Factors: In rare cases, people inherit gene mutations that increase their risk of colon polyps forming. These genetic predispositions significantly raise the chances of developing colon cancer. Early screening is crucial to catch and address these issues.

Inherited Disorders: Some inherited conditions dramatically increase the risk of colon polyps and cancer. These include:

• Lynch syndrome (hereditary nonpolyposis colorectal cancer): People with this condition tend to develop fewer polyps, but the polyps they do develop can become cancerous more quickly. Lynch syndrome is the most common inherited form of colon cancer and can also cause tumors in other parts of the abdomen.

• Familial adenomatous polyposis (FAP): This rare condition causes hundreds or even thousands of polyps to grow in the colon, typically starting in adolescence. Untreated, the risk of colon cancer is very high, often developing before age 40. Genetic testing can help assess the risk of FAP.

• Gardner syndrome: This is a type of FAP where polyps form in both the colon and small intestine. People with Gardner syndrome may also develop non-cancerous tumors in other parts of the body, such as the skin, bones, and abdomen.

• MUTYH-associated polyposis (MAP): Similar to FAP, MAP is caused by changes in the MYH gene. People with MAP often develop multiple adenomatous polyps and colon cancer at a young age. Genetic testing can help determine the risk of MAP.

• Peutz-Jeghers syndrome: This condition typically begins with the development of freckles all over the body, including the lips, gums, and feet. Then, non-cancerous polyps form throughout the intestines. These polyps can become cancerous, increasing the risk of colon cancer.

• Serrated polyposis syndrome: This condition leads to multiple serrated adenomatous polyps, primarily in the upper part of the colon. These polyps can become cancerous and need careful monitoring and possible removal.

Early Detection and Screening: Regular screening, often starting at age 45 or earlier depending on individual risk factors, can greatly improve the chances of detecting colon polyps or cancer early. Early detection allows for timely intervention and often prevents the cancers from growing or spreading.

Some growths in the colon, called polyps, can sometimes turn into cancer. Removing these polyps early greatly reduces the chance that they will develop into cancer. In simpler terms, catching and removing polyps early on lowers the risk of them becoming cancerous.

Regular screenings can significantly lower your chances of getting colon polyps and colorectal cancer. Making some lifestyle changes can also help.

Healthy Habits Make a Difference:

Eating a lot of fruits, vegetables, and whole grains, and reducing your fat intake, are good steps. Also, limiting alcohol and quitting smoking are important. Staying active and keeping a healthy weight are key parts of this. These lifestyle changes will positively impact your overall health, and help reduce your risk of colon problems.

Calcium and Vitamin D:

Studies suggest that getting enough calcium might help prevent colon polyps from coming back. But, it's not yet clear if calcium directly prevents colon cancer. Other research shows vitamin D might protect against colorectal cancer. Talking to your doctor about how much calcium and vitamin D you need is a good idea, especially if you have a concern about your risk. Your doctor can advise you on the right amount for your specific situation.

High-Risk Considerations:

If you have a family history of colon polyps, a genetic counselor can help you understand your risk and discuss options. If you have a genetic condition that increases your risk of colon polyps, regular colonoscopies are often recommended starting when you are young. This is because early detection is crucial for preventing serious problems. Colon cancer is much easier to treat when found early. So, if you have concerns about your family history or genetic predispositions, discussing these with your doctor is important.

Early Detection of Colon Problems is Key

Finding colon polyps and colorectal cancer early is vital for successful treatment. These screenings can often catch problems when they're small and easier to treat.

Different screening methods exist:

• Colonoscopy: A colonoscopy uses a thin, flexible tube with a camera and light to examine the entire colon. If polyps are found, the doctor can often remove them during the procedure or take a tissue sample for testing.

• Virtual Colonoscopy: This test uses a CT scan to create images of the colon. Similar to a regular colonoscopy, preparation is needed. If a polyp is spotted, a colonoscopy is needed to remove it.

• Flexible Sigmoidoscopy: This test is like a colonoscopy but only looks at the lower portion of the colon (the sigmoid). It misses parts of the colon, so some polyps and cancers might not be detected.

• Stool-Based Tests: These tests look for blood or DNA in your stool that might indicate a polyp or cancer. A positive stool test usually requires a colonoscopy to follow up.

Who Should Get Screened?

Doctors generally recommend screening for adults age 50 and older, and even for those older with a good life expectancy. Dr. Kisiel emphasizes that even if you're healthy, these screenings are important.

How Common Are Polyps?

Colonoscopies frequently reveal polyps, which are growths in the colon. In fact, doctors often find polyps in more than a quarter of colonoscopies, and sometimes even a half or more. While these precancerous growths are common, they don't always lead to cancer.

The Risk of Colon Cancer

While 1 in 20 Americans will develop colorectal cancer in their lifetime, most polyps don't become cancerous. Some polyps may disappear on their own. However, removing polyps is a key way to prevent cancer.

Why is Screening Important?

Regular screening is crucial because it allows for early detection of polyps. While a polyp diagnosis might mean more frequent screenings in the future, it's significantly better than needing treatment for colorectal cancer.