Concerns About a 0.9cm Flat Polyp: Should I Seek a Specialist?

Colonic polyp measuring 0.8 cm?

Hello Doctor: I found a 0.9 cm polyp during my health check-up, which is flat type (0-IIa).
Since 0.9 cm is relatively large, I was advised to have it removed at a major hospital.
I also brought the diagnosis report and photos from the health check-up center to show the doctor at the major hospital.
I consulted with a gastroenterologist, who arranged for a colonoscopy.
However, after about 15 minutes, the doctor said he could not locate the polyp despite searching twice and suggested that I return for follow-up in a year.
I am very worried that this polyp might develop into colorectal cancer while I wait for a year.
What should I do? Should I consult a colorectal surgeon instead, as they might be more specialized? Thank you, Doctor.

A-Zheng, 40~49 year old female. Ask Date: 2024/01/23

Dr. Hu Guozheng reply Gastroenterology and Hepatology

It is recommended to bring both reports and photos from the two visits to the outpatient clinic for discussion.

Reply Date: 2024/01/23

More Info

When it comes to concerns about a 0.9 cm flat polyp, especially one that has been identified during a health check-up, it is understandable to feel anxious about the potential for it to develop into something more serious, such as colorectal cancer. The fact that you have already undergone a colonoscopy and the physician was unable to locate the polyp can add to your concerns. Here’s a comprehensive approach to your situation.

Firstly, it’s important to understand that flat polyps, particularly those that are larger than 1 cm, can have a higher risk of being precancerous or cancerous compared to smaller polyps. The classification of the polyp as type 0-IIa indicates that it is flat and may require careful monitoring or removal, depending on its characteristics. The recommendation from the health check-up center to have it removed is a prudent one, especially given its size.

Since the gastroenterologist you consulted was unable to find the polyp during the colonoscopy, it may be beneficial to seek a second opinion from a colorectal surgeon or a specialist in colorectal surgery. Colorectal surgeons have extensive training in both the surgical and non-surgical management of colorectal diseases, including polyps. They may also have more advanced techniques or tools at their disposal for locating and removing polyps that may not be easily visible during a standard colonoscopy.

In the meantime, it is crucial to maintain regular follow-ups. If the gastroenterologist has suggested waiting a year for a follow-up colonoscopy, you should consider whether this timeline aligns with your comfort level and the potential risks associated with the polyp. If you feel uncertain or anxious about waiting, do not hesitate to express these concerns to your healthcare provider. They may be able to offer reassurance or alternative options, such as scheduling an earlier follow-up or referring you to a colorectal specialist.

Additionally, it is essential to be proactive about your health. Keep track of any changes in your bowel habits, such as blood in your stool, changes in stool consistency, or unexplained weight loss, and report these to your doctor immediately. These symptoms can be indicative of more serious conditions and should be evaluated promptly.

In summary, given your situation, seeking a consultation with a colorectal surgeon may provide you with the specialized care and peace of mind you need. They can evaluate your case more thoroughly, discuss the risks and benefits of polyp removal, and help you develop a personalized monitoring plan. Remember, being proactive and informed about your health is key to managing your concerns effectively.

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