Early Detection, Removal of Polyps Key in Colon Cancer Prevention

DAYTON, Ohio (March 24, 2020) – The death rate from colorectal cancer has been dropping in both men and women for several decades thanks to a push to have adults screened for the disease to catch it at an earlier stage, according to the American Cancer Society (ACS).

Screening for colorectal cancer can often find polyps – or abnormal growths – in the colon or rectum before they become cancer or spread to other parts of the body. Polyps are removed at the time of a colonoscopy, which is the most common and effective type of screening for the disease.

“A polyp will eventually become cancerous if left untreated. That process can take about 10 years,” said Matthew Doepker, MD, a surgeon with Premier Surgical Oncology. “That’s why we screen patients with colonoscopies at age 50. Because if there is a polyp, then we can potentially remove it and eradicate the potential cause of cancer.”

Not all polyps are the same, and not all of them will become cancer. Each type of polyp carries with it a varying degree of risk for malignancy, said Dr. Doepker, who practices with Premier Physician Network.

The two most common types of polyps found in the colon or rectum are hyperplastic and adenomas. Hyperplastic polyps are typically benign – meaning they are neither pre-cancers nor cancers – and are not cause for concern.

An adenoma polyp is made up of tissue that looks much like the colon’s normal lining, although it is different in several important ways when examined under the microscope, according to ACS. Adenoma polyps have various growth patterns and are classified in this way when they are examined in a lab and reported back to the patient.

Most important is that a polyp is completely removed, the ACS said. However, the growth pattern can help determine when follow-up screening needs to take place. Many different terms can appear on a pathology report that is generated from the examination of a polyp. Knowing the meaning of these words can help a person to better understand what was found.

Tubular and Villous – These are the two major growth patterns found. Most adenomas that are less than ½ inch in size have a tubular pattern. Larger adenomas may have a villous growth pattern. Larger adenomas and those with a villous pattern often have cancer developing in them.

Sessile – Polyps that tend to grow as slightly flattened with a broad base.

Serrated – Adenoma polyps that have a saw-toothed appearance when viewed under a microscope. These growths come in two different types called sessile serrated and traditional serrated. These polyps are not cancer, but are pre-cancerous, which means they can turn into cancer.

Dysplasia – These types of polyps come in two different degrees. A low-grade dysplasia is a polyp that doesn’t look much like cancer. A high-grade dysplasia is more abnormal and looks more like cancer. If a high-grade dysplasia is found then a repeat colonoscopy may happen sooner than normal.

Those who are found to have an adenoma polyp will need to schedule follow-up colonoscopies to ensure that more polyps do not form. The timing of the next colonoscopy is determined by the number of polyps that are found at one time and the details of the polyp from the pathology.

“Patients who are found to have polyps at an early age will likely have additional polyps throughout their lives,” Dr. Doepker said. “Some of that is based on their diet, and some is based on genetics. There are also certain syndromes – such as Crohn’s disease or inflammatory bowel syndrome – where patients may develop more polyps than others.”

Risk factors can help determine if person may be more likely to develop the disease; however, in most cases, colon cancer is sporadic.

“It can be a disease that just shows up with no known risk factors,” Dr. Doepker said. “For this reason, screening at the recommended age becomes the most important step in prevention.”

For more information about colon cancer or to or to schedule an appointment with a Premier Physician Network physician near you, visit PremierPhysicianNetwork.com/physician.

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