Polyp Panic? Not So Fast! Your Colonoscopy Results Explained
Impact of Colon Polyp Size, Formation, and Development Stage on Colon Cancer Threat
You've just had a colonoscopy and the results have you a little alarmed. The word "polyps" in the report has you thinking you might be dealing with colorectal cancer. But hold your horses, let's break it down.
First things first, finding polyps in your colon or rectum doesn't automatically mean you've got cancer. These growths are common, especially for folks over 45, and often harmless. But that doesn't mean they should be ignored, warns colorectal surgeon Rebecca Gunter, MD. After all, colorectal cancer starts in polyps.
So, what's the difference between good and bad polyps? Here's the lowdown on polyp sizes, shapes, and growth patterns.
Size Matters: Go Big or Go Home?
When it comes to polyps, the smaller the better. Polyps range from the tiniest, match-head-sized "diminutive" ones, to the thumb-sized "giants." Around 95% of polyps are diminutive, and fewer than 1 in 50 of these are likely to be cancerous. However, as polyps grow, the risk of cancer rises. It's estimated it takes about 10 years for cancer to grow from a polyp.
Shape Shifters: Polyps Aren't One-Size-Fits-All
Polyps come in three basic shapes:
- Sessile polyps are flat and grow directly on your colon wall. They make up around 85% of polyps and are relatively easy to remove during a colonoscopy, even if they're large.
- Pedunculated polyps hang from a stalk, making them easier to spot and usually easier to remove in one piece during a colonoscopy. Cancer can develop on the head of pedunculated polyps.
- Flat polyps are the least common and are often hard to see and remove.
Spot the Difference: The Microscopic Mission
Doctors examine the removed polyps under a microscope to check the cells. If they see disorganized cells with a larger, darker center, that indicates high-grade dysplasia. These cells often grow wildly, which could mean cancer was close to forming in the polyp. If you have polyps with high-grade dysplasia, your healthcare provider may recommend a follow-up colonoscopy sooner than usual.
If the cells look only mildly abnormal, it means the polyp has low-grade dysplasia and is of less concern.
Adenomas: A Wilson Pickett Special
Adenomas are a specific type of polyp. There are three kinds of adenomas: tubular, villous, and tubulovillous. They can be identified by their appearance under a microscope. Tubular adenomas are small, tubular, and relatively harmless. Villous adenomas are larger and more likely to be cancerous due to their chaotic growth pattern. Tubulovillous adenomas have characteristics of both tubular and villous adenomas.
Serrated Polyps: The Ghost in the Machine
Serrated polyps look like saw teeth under the microscope. They're subtle and easy to overlook, but around 25% of colon cancers come from serrated polyps.
The Great Polyp Purge
The good news is that all polyps can be removed. While not all polyps turn into cancer, all colorectal cancers start as polyps. And if you keep up with your colonoscopies, your doctors can eliminate any threats posed by polyps. Colonoscopies are recommended for everyone starting at 45, or earlier if you have higher risk factors.
Folks, the truth is that colon polyps are quite common. But the good news is that removing them decreases your risk of colorectal cancer. A colonoscopy is a safe, effective procedure that could save your life. So don't delay! Get it done!
- The presence of polyps in your colon or rectum doesn't necessarily mean you have colorectal cancer; in fact, the smaller the polyp, the less likely it is to be cancerous.
- Adenomas, a specific type of polyp, can be identified by their appearance under a microscope, and while some adenomas (like villous adenomas) are more likely to be cancerous due to their chaotic growth pattern, others (like tubular adenomas) are relatively harmless.
- Serrated polyps are subtle and easy to overlook, but they are significant because around 25% of colon cancers originate from these polyps, emphasizing the importance of taking polyps seriously and undergoing regular colonoscopies to mitigate the risk of colorectal cancer.
