Table of ContentsView AllTable of ContentsWhat Are Polyps?Types of PolypsCharacteristicsRisk FactorsDiagnosisTreatmentPrevention
Table of ContentsView All
View All
Table of Contents
What Are Polyps?
Types of Polyps
Characteristics
Risk Factors
Diagnosis
Treatment
Prevention
Different types ofcolon polypshave various shapes or growth patterns. Tubular polyps, for example, have a growth pattern that resembles regularly spaced tubes. Villous polyps have a leaf-like growth pattern, and tubulovillous polyps show a combination of both growth patterns.
Identifying the type of polyp you have can help your healthcare provider understand your risk for colon cancer and develop a treatment and prevention plan to help lower your risk.
This article looks at the different types of colon polyps, including their relationship tocancers of the colon or rectum. It also describes the symptoms and causes of colon polyps as well as the current colon cancer screening recommendations in the United States.
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What Are Colonic Polyps?
In most cases, colon polyps do not cause any symptoms. Because of this, polyps can go undetected until they are found during a routine colonoscopy.
When polyps do cause symptoms, they may include:
Types of Colon Polyps
There are different types of colon polyps, each of which has its own characteristics and structure. These and other factors (including the size and location of a polyp) can help determine the potential risk of cancer.
There are five broad categories of colon polyps as well as “mixed” types that have characteristics of two or more polyp types.
Tubular Adenomas
Tubular adenomasmake up around two-thirds of all colon polyps. They are one of two types ofadenomatous polypsthat can develop in the colon’s inner lining.
Adenomatous polyps, also known as adenomas, originate in epithelial tissues (the thin layer covering organs, cavities, and vessels of the body). Tubular adenomas as so-named because they tend to form in an orderly tubular shape.
Tubular adenomas are considered low risk for developing into cancer.
What Is a Neoplasm?Adenomas are neoplastic. The termneoplasiadescribes an abnormal growth of cells that gradually lose the characteristics of normal cells. When neoplastic cells form into a mass, it is called aneoplasm(tumor). Neoplasms can bebenign(non-cancerous),malignant(cancerous), orprecancerous.
What Is a Neoplasm?
Adenomas are neoplastic. The termneoplasiadescribes an abnormal growth of cells that gradually lose the characteristics of normal cells. When neoplastic cells form into a mass, it is called aneoplasm(tumor). Neoplasms can bebenign(non-cancerous),malignant(cancerous), orprecancerous.
Villous Adenomas
Villousadenomas are another type of adenomatous polyp that has a greater potential of becoming cancerous. While less common than tubular adenomas, around 30% of villous adenomas will turn into colon or rectal cancer.
The termvillousdescribes the finger-like projection (villi) on the surface of the epithelial tissues. Unlike tubular adenomas that develop in an orderly fashion, villous adenomas develop haphazardly and often have a cauliflower-like appearance.
Tubulovillous Adenomas
Some adenomas share characteristics of both tubular and villous adenomas, calledtubulovillous adenomas. These have a greater potential for turning cancerous than tubular adenomas but less than villous adenomas.
Hyperplastic Polyps
Hyperplastic polyps are a type of polyp that rarely ever turns cancerous. The termhyperplasiasimply describes an abnormal increase in the number of cells that causes tissues to enlarge.(Benign prostatic hyperplasia, for example, is the term used to describe an enlarged prostate.)
Hyperplastic adenomas tend to develop in parts of thedigestive tractwhere tissues have been previously damaged. Hyperplastic polyps are usually small and situated in the lower end of the colon, such as the rectum andsigmoid colon.
Hyperplastic polyps are considered to be non-neoplastic.
Inflammatory Polyps
As with hyperplastic polyps, inflammatory polyps are non-neoplastic and, as such, have a very low potential for turning cancerous.
Inflammatory polyps are sometimes referred to aspseudopolyps(“false polyps”) because they aren’t polyps per se but rather an inflammatory complication of IBD.
Hamartomatous Polyps
Hamartomatous polypsare a rare type of colon polyp typically seen in children. They may manifest with a single polyp or multiple polyps.
Hamartomatous polyps are considered an inherited genetic condition. While the polyps are non-neoplastic, they are still linked to an increased risk of colon cancer, albeit in different ways.
It is thought that cancer may not arise from the polyps themselves but rather from inherited genetic errors that causestem cellsto divide abnormally.(Stem cells are unspecialized cells that can transform into specialized cells based on signaling molecules, called growth factors, that “tell” the cell what to become.)
Colon Polyps and Your Cancer Risk
Shapes and Characteristics of Colon Polyps
When describing a polyp, a diagnostic specialist known as apathologistwill use different terms to describe the characteristics of the growth. Some of these characteristics are linked to an increased risk of colon cancer.
Colon polyps can be described in the following ways:
There are bothsessile serrated polypsthat have a high potential for turning cancerous on their own andtraditional serrated polypsthat are usually found further up the colon and often turn cancerous because they are missed during a colonoscopy.
What Is a Polypectomy?
Causes and Risk Factors
Scientists are not exactly sure why some people get colon polyps, and others do not. There is evidence that genetics play a part. This includes having so-calledAPC, TP53, andKRASgene mutations, which often run in families.
Certain people are at greater risk of polyps due to non-modifiable (unchangeable) risk factors, such as:
There are also modifiable (changeable) risk factors that may contribute to the onset of colon polyps, including:
Colon polyps are usually found during a routine colonoscopy. Other tests can suggest the presence of polyps. For example, a fecal immunochemical test (FIT) or a fecal occult blood test (FOBT) can look for small amounts of blood in your stool. A positive result could mean you have polyps that will need to be removed during a colonoscopy.
How Are Colon Polyps Treated?
Colonic polyps are typically removed during a colonoscopy. This is done with biopsy forceps or a wire loop that uses an electric current to burn through the tissue. The polyp is usually collected and then sent to a laboratory so it can be tested for cancer.
If you have polyps removed, you will need to repeat your colonoscopy sooner than what would be recommended if you did not have polyps. How soon depends on the polyps' size, number, and type.
How Are Colon Polyps Prevented?
Certain risk factors such as your age and family history of colon polyps can’t be changed. However, there may be ways to reduce your chances of developing polyps. The most important of these is your diet. Eating more fruits and vegetables and decreasing your intake of red meat may help reduce your risk of developing polyps.
Other lifestyle choices may also play a role in the development of colon polyps, including:
Calcium,folic acid supplements, and a daily low dose of aspirin may also protect against the development of polyps in some people.
Colon Cancer Screening
The best way to avoid colon cancer is to undergo routinecolorectal cancer screening, Updated guidelines from the American Cancer Societyand U.S. Preventive Service Task Forcerecommend screening starting at age 45 for adults at average risk of the disease.
The screening should be repeated every one to 10 years based on the type of test used:
When Is a Polyp Removed?Any polyp with a villous component or a diameter greater than 1 centimeter (regardless of type) is typically removed since it is considered to be at high risk for becoming cancer.
When Is a Polyp Removed?
Any polyp with a villous component or a diameter greater than 1 centimeter (regardless of type) is typically removed since it is considered to be at high risk for becoming cancer.
Those at high risk because of a family history of colon cancer or other factors can be screened at an earlier age and tested more frequently.
How Many Polyps Are Normal in a Colonoscopy?If you have only one or two polyps and they are 5mm in diameter or smaller, you have a low risk of developing colon cancer. Larger polyps and higher numbers of polyps increase your chance of developing colon cancer.
How Many Polyps Are Normal in a Colonoscopy?
If you have only one or two polyps and they are 5mm in diameter or smaller, you have a low risk of developing colon cancer. Larger polyps and higher numbers of polyps increase your chance of developing colon cancer.
This Low-cost Cologuard Alternative Is Just as Effective at Colorectal Cancer Screening
Summary
Colon polyps are abnormal tissue growths in the colon’s lining (large intestine). Many polyps are harmless, but some have the potential to turn cancerous.
To prevent polyps from turning cancerous, routine colon cancer screening is recommended. This includes direct and indirect screening methods such as colonoscopy, sigmoidoscopy, virtual colonoscopy, or stool-based tests.
Precancerous or Cancerous Biopsy for Polyps: What Happens Next?
16 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Shussman N, Wexner SD.Colorectal polyps and polyposis syndromes.Gastroenterol Rep (Oxf). 2014;2(1):1-15. doi:10.1093/gastro/got041Haumaier F, Sterlacci W, Vieth M.Histological and molecular classification of gastrointestinal polyps.Best Pract Res Clin Gastroenterol. 2017;31(4):369-379. doi:10.1016/j.bpg.2017.06.005American Cancer Society.Your colon or rectal pathology report: polyps (including serrated adenomas).Mitchem JB, Hall JF.Adenomatous polyposis syndromes: diagnosis and management.Clin Colon Rectal Surg.2016;29(4):321–9. doi:10.1055/s-0036-1584089Click B, Pinsky PF, Hickey T, Doroudi M, Schoen RE.Association of colonoscopy adenoma findings with long-term colorectal cancer incidence.JAMA. 2018;319(19):2021-31. doi:10.1001/jama.2018.5809Crohn’s and Colitis Foundation.The risk of colorectal cancer in Crohn’s disease and ulcerative colitis patients.Politis DS, Katsanos KH, Tsianos EV, Christodoulou DK.Pseudopolyps in inflammatory bowel diseases: Have we learned enough?World J Gastroenterol.2017;23(9):1541-1551. doi:10.3748/wjg.v23.i9.1541Cone MM.Hamartomatous polyps and associated syndromes.Clin Colon Rectal Surg.2016;29(4):330–5. doi:10.1055/s-0036-1582441Wolff RK, Hoffman MD, Wolff EC, et al.Mutation analysis of adenomas and carcinomas of the colon: early and late drivers.Genes Chromosomes Cancer. 2018;57(7):366-76. doi:10.1002/gcc.22539American Cancer Society.Guideline for colorectal cancer screening.Stanford Medicine.Colon polyps diagnosis.American Society for Gastrointestinal Endoscopy.Understanding polyps and their treatment.American Cancer Society.Can colorectal cancer be prevented?US Preventive Services Task Force, Bibbins-Domingo K, Grossman DC, et al.Screening for colorectal cancer: US Preventive Services Task Force recommendation statement.JAMA. 2016;315(23):2564-2575. doi:10.1001/jama.2016.5989Molmenti CL, Kolb JM, Karlitz JJ.Advanced colorectal polyps on colonoscopy: a trigger for earlier screening of family members.Am J Gastroenterol. 2020;115(3):311-314. doi:10.14309/ajg.0000000000000467Harvard Health Publishing.They found colon polyps: Now what?
16 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Shussman N, Wexner SD.Colorectal polyps and polyposis syndromes.Gastroenterol Rep (Oxf). 2014;2(1):1-15. doi:10.1093/gastro/got041Haumaier F, Sterlacci W, Vieth M.Histological and molecular classification of gastrointestinal polyps.Best Pract Res Clin Gastroenterol. 2017;31(4):369-379. doi:10.1016/j.bpg.2017.06.005American Cancer Society.Your colon or rectal pathology report: polyps (including serrated adenomas).Mitchem JB, Hall JF.Adenomatous polyposis syndromes: diagnosis and management.Clin Colon Rectal Surg.2016;29(4):321–9. doi:10.1055/s-0036-1584089Click B, Pinsky PF, Hickey T, Doroudi M, Schoen RE.Association of colonoscopy adenoma findings with long-term colorectal cancer incidence.JAMA. 2018;319(19):2021-31. doi:10.1001/jama.2018.5809Crohn’s and Colitis Foundation.The risk of colorectal cancer in Crohn’s disease and ulcerative colitis patients.Politis DS, Katsanos KH, Tsianos EV, Christodoulou DK.Pseudopolyps in inflammatory bowel diseases: Have we learned enough?World J Gastroenterol.2017;23(9):1541-1551. doi:10.3748/wjg.v23.i9.1541Cone MM.Hamartomatous polyps and associated syndromes.Clin Colon Rectal Surg.2016;29(4):330–5. doi:10.1055/s-0036-1582441Wolff RK, Hoffman MD, Wolff EC, et al.Mutation analysis of adenomas and carcinomas of the colon: early and late drivers.Genes Chromosomes Cancer. 2018;57(7):366-76. doi:10.1002/gcc.22539American Cancer Society.Guideline for colorectal cancer screening.Stanford Medicine.Colon polyps diagnosis.American Society for Gastrointestinal Endoscopy.Understanding polyps and their treatment.American Cancer Society.Can colorectal cancer be prevented?US Preventive Services Task Force, Bibbins-Domingo K, Grossman DC, et al.Screening for colorectal cancer: US Preventive Services Task Force recommendation statement.JAMA. 2016;315(23):2564-2575. doi:10.1001/jama.2016.5989Molmenti CL, Kolb JM, Karlitz JJ.Advanced colorectal polyps on colonoscopy: a trigger for earlier screening of family members.Am J Gastroenterol. 2020;115(3):311-314. doi:10.14309/ajg.0000000000000467Harvard Health Publishing.They found colon polyps: Now what?
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Shussman N, Wexner SD.Colorectal polyps and polyposis syndromes.Gastroenterol Rep (Oxf). 2014;2(1):1-15. doi:10.1093/gastro/got041Haumaier F, Sterlacci W, Vieth M.Histological and molecular classification of gastrointestinal polyps.Best Pract Res Clin Gastroenterol. 2017;31(4):369-379. doi:10.1016/j.bpg.2017.06.005American Cancer Society.Your colon or rectal pathology report: polyps (including serrated adenomas).Mitchem JB, Hall JF.Adenomatous polyposis syndromes: diagnosis and management.Clin Colon Rectal Surg.2016;29(4):321–9. doi:10.1055/s-0036-1584089Click B, Pinsky PF, Hickey T, Doroudi M, Schoen RE.Association of colonoscopy adenoma findings with long-term colorectal cancer incidence.JAMA. 2018;319(19):2021-31. doi:10.1001/jama.2018.5809Crohn’s and Colitis Foundation.The risk of colorectal cancer in Crohn’s disease and ulcerative colitis patients.Politis DS, Katsanos KH, Tsianos EV, Christodoulou DK.Pseudopolyps in inflammatory bowel diseases: Have we learned enough?World J Gastroenterol.2017;23(9):1541-1551. doi:10.3748/wjg.v23.i9.1541Cone MM.Hamartomatous polyps and associated syndromes.Clin Colon Rectal Surg.2016;29(4):330–5. doi:10.1055/s-0036-1582441Wolff RK, Hoffman MD, Wolff EC, et al.Mutation analysis of adenomas and carcinomas of the colon: early and late drivers.Genes Chromosomes Cancer. 2018;57(7):366-76. doi:10.1002/gcc.22539American Cancer Society.Guideline for colorectal cancer screening.Stanford Medicine.Colon polyps diagnosis.American Society for Gastrointestinal Endoscopy.Understanding polyps and their treatment.American Cancer Society.Can colorectal cancer be prevented?US Preventive Services Task Force, Bibbins-Domingo K, Grossman DC, et al.Screening for colorectal cancer: US Preventive Services Task Force recommendation statement.JAMA. 2016;315(23):2564-2575. doi:10.1001/jama.2016.5989Molmenti CL, Kolb JM, Karlitz JJ.Advanced colorectal polyps on colonoscopy: a trigger for earlier screening of family members.Am J Gastroenterol. 2020;115(3):311-314. doi:10.14309/ajg.0000000000000467Harvard Health Publishing.They found colon polyps: Now what?
Shussman N, Wexner SD.Colorectal polyps and polyposis syndromes.Gastroenterol Rep (Oxf). 2014;2(1):1-15. doi:10.1093/gastro/got041
Haumaier F, Sterlacci W, Vieth M.Histological and molecular classification of gastrointestinal polyps.Best Pract Res Clin Gastroenterol. 2017;31(4):369-379. doi:10.1016/j.bpg.2017.06.005
American Cancer Society.Your colon or rectal pathology report: polyps (including serrated adenomas).
Mitchem JB, Hall JF.Adenomatous polyposis syndromes: diagnosis and management.Clin Colon Rectal Surg.2016;29(4):321–9. doi:10.1055/s-0036-1584089
Click B, Pinsky PF, Hickey T, Doroudi M, Schoen RE.Association of colonoscopy adenoma findings with long-term colorectal cancer incidence.JAMA. 2018;319(19):2021-31. doi:10.1001/jama.2018.5809
Crohn’s and Colitis Foundation.The risk of colorectal cancer in Crohn’s disease and ulcerative colitis patients.
Politis DS, Katsanos KH, Tsianos EV, Christodoulou DK.Pseudopolyps in inflammatory bowel diseases: Have we learned enough?World J Gastroenterol.2017;23(9):1541-1551. doi:10.3748/wjg.v23.i9.1541
Cone MM.Hamartomatous polyps and associated syndromes.Clin Colon Rectal Surg.2016;29(4):330–5. doi:10.1055/s-0036-1582441
Wolff RK, Hoffman MD, Wolff EC, et al.Mutation analysis of adenomas and carcinomas of the colon: early and late drivers.Genes Chromosomes Cancer. 2018;57(7):366-76. doi:10.1002/gcc.22539
American Cancer Society.Guideline for colorectal cancer screening.
Stanford Medicine.Colon polyps diagnosis.
American Society for Gastrointestinal Endoscopy.Understanding polyps and their treatment.
American Cancer Society.Can colorectal cancer be prevented?
US Preventive Services Task Force, Bibbins-Domingo K, Grossman DC, et al.Screening for colorectal cancer: US Preventive Services Task Force recommendation statement.JAMA. 2016;315(23):2564-2575. doi:10.1001/jama.2016.5989
Molmenti CL, Kolb JM, Karlitz JJ.Advanced colorectal polyps on colonoscopy: a trigger for earlier screening of family members.Am J Gastroenterol. 2020;115(3):311-314. doi:10.14309/ajg.0000000000000467
Harvard Health Publishing.They found colon polyps: Now what?
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