Colon Polyps: Risks, Screening, and Prevention Strategies

Colorectal polyp

Hello Doctor, I underwent a colonoscopy screening in April 2017, but recently I have been experiencing frequent bowel movements with loose stools, going to the bathroom 7 to 8 times a day.
Additionally, there is a family history of colorectal cancer.
Therefore, I requested another colonoscopy from a gastroenterologist at the beginning of 2018, and a polyp was found again, which has made me very worried! The pathology report from 2017 states: Diagnosis: Tubular adenoma, sigmoid colon, 25 cm level, biopsy and removal.
Gross description: The specimen is composed of two pieces of tan tissue measuring 0.4*0.3*0.3 cm, all embedded in one cassette.
Microscopic description: The polyp consists of crowded tubuloglandular structures lined by dysplastic epithelial cells.
The lamina propria is edematous with chronic inflammatory cell infiltration.
No malignant transformation is observed in this sample.

I have the following questions for the doctor:
1.
Why has another polyp developed in just six months? I have been very careful with my diet and exercise briskly for 2 hours every day.
If it is another adenomatous polyp, am I destined to develop cancer?
2.
Is it appropriate to have a colonoscopy every six months to one year?
3.
If adenomatous polyps are consistently found during future examinations and are removed during the colonoscopy, can this prevent the development of colorectal cancer? (Removal during each annual examination)

Mr. He, 30~39 year old female. Ask Date: 2018/01/06

Dr. Chen Shidian reply Gastroenterology and Hepatology

Hello, please cooperate with your attending physician for follow-up.
There's no need to worry, as the chance of cancerous transformation for polyps smaller than 1 centimeter is very low.
Some very small polyps may not be easily visible and are not necessarily new growths, so please do not be concerned.
Changhua Hospital cares about your health.
Chen Shidian

Reply Date: 2018/01/06

More Info

Understanding colon polyps is crucial for anyone concerned about colorectal health, especially individuals with a family history of colorectal cancer. Colon polyps are growths on the lining of the colon that can vary in size and type. The most common types include adenomatous polyps, which can potentially develop into cancer over time, and hyperplastic polyps, which are generally considered benign.

Given your situation, where you have a family history of colorectal cancer and have experienced changes in your bowel habits, it’s understandable to feel anxious about the presence of polyps. The fact that you had a tubular adenoma removed previously indicates that you are at a higher risk for developing additional polyps, as adenomatous polyps can recur.
1. Why did another polyp develop so soon?
The recurrence of polyps within a short time frame, such as six months, can occur for several reasons. Genetic predisposition plays a significant role; if there is a family history of colorectal cancer, your risk of developing polyps increases. Additionally, lifestyle factors, although you mentioned you are exercising and eating well, can still contribute to polyp formation. It’s essential to maintain a balanced diet rich in fiber, fruits, and vegetables while limiting red and processed meats, as these dietary choices can influence polyp development.

2. Is it appropriate to have a colonoscopy every six months to a year?
For individuals with a history of adenomatous polyps, especially if they are dysplastic (showing abnormal cells), more frequent surveillance is recommended. The typical guideline suggests that if you have had one or more adenomatous polyps, a follow-up colonoscopy should be performed in three years. However, if you have a family history of colorectal cancer, your healthcare provider may recommend more frequent screenings. Discussing your specific case with your gastroenterologist will help determine the best schedule for your follow-up colonoscopies.

3. Can regular removal of adenomatous polyps prevent colorectal cancer?
Yes, regular surveillance and removal of adenomatous polyps can significantly reduce the risk of developing colorectal cancer. If polyps are detected and removed during colonoscopy, the likelihood of cancer developing from those polyps is greatly diminished. The key is to adhere to the recommended screening schedule and to have any polyps removed as soon as they are identified.
In summary, while the presence of adenomatous polyps can be concerning, proactive management through regular screenings and lifestyle modifications can help mitigate the risk of colorectal cancer. It’s essential to maintain open communication with your healthcare provider about your family history and any symptoms you experience. They can provide personalized recommendations based on your health status and family history, ensuring that you receive the appropriate care and monitoring. Remember, early detection and intervention are vital in managing colorectal health effectively.

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