Polyps aren’t unique to the colon. These small clumps of cells can form in many places, including your stomach, ear canal, bladder, nose and throat. Inside your colon, polyps often are benign (or harmless) and amount to little more than a freckle. There are others, however, that can become cancerous if left unaddressed. Unfortunately, you can have one or more of these precancerous polyps and never realize it. Oftentimes, there are no symptoms—no bleeding, no constipation or changes in bowel habits, no unexplained weight loss and no pain.
Researchers still don’t know for certain what causes polyps to form. There are some relatively rare genetic disorders, including Lynch syndrome and familial adenomatous polyposis, that significantly increase your risk for polyps. But the simple truth is that they can develop out of the blue. Still, several risk factors are connected to polyps and colon cancer, including the following examples.
Family history: If you have a parent, sibling or child who has had polyps or colon cancer, then your risk goes up. If you have multiple family members affected, the risk is even greater. However, this may not be the result of genetics. It may amount to shared environmental factors.
Age: Colon polyps are more likely to be found in those over the age of 50. Cells in your body are dying and being replaced daily. Every time a dead cell is replaced, there is a tiny chance that the new cell could become cancerous due to an error in the body’s copying mechanism.
Obesity and lack of exercise: Researchers suggest that individuals who are overweight or inactive may face an increased risk due to fewer bowel movements. This could lead to the colon lining being exposed to carcinogens in certain foods for extended periods.
Inflammatory intestinal conditions: Both ulcerative colitis and Crohn’s disease can increase the risk of developing cancer.
Smoking and alcohol: Drinking three or more alcoholic drinks a day can increase your risk for polyps. Adding smoking to the mix may further increase that risk.
Race: Black Americans are at a higher risk of developing colorectal cancer, with an incidence rate that is 20% higher than that of white Americans.
Detection
Polyps are usually discovered as part of a diagnostic colonoscopy, a procedure used to examine your large intestine (colon) and rectum for signs of colon cancer. What happens next depends on the size, location and type of polyp.
Smaller polyps will often be removed during the colonoscopy. Larger polyps may require an additional procedure. And in some instances, the polyp may already have cancerous cells, which may call for removal of a section of the colon.
Sometimes during the colonoscopy, your doctor will be able to determine, by appearance, whether or not a polyp is precancerous. But often, the only way to know is to remove the tissue and send it to the lab for analysis. That’s why the default approach is to remove any polyp, if possible, during the procedure.
Following your colonoscopy, your doctor will discuss the results and anything you should be concerned about. This could include the discovery of precancerous (adenomatous) polyps, multiple polyps, large polyps and polyps with a history of bleeding.
Your doctor may also suggest increasing the frequency of your colon cancer screenings.
Screening
A colonoscopy remains the gold standard for colon cancer screening. It is the most accurate tool currently available, and it allows your doctor the ability to remove polyps discovered during the procedure. There are other approved options, including a virtual colonoscopy and stool-based tests that require you to collect and submit a stool sample for analysis. However, the alternatives are less accurate, which means they need to be repeated more frequently–sometimes annually. Positive findings from these tests make a colonoscopy essential for further evaluation.
A concerning trend in recent years is the rising incidence of colon cancer, one of the few cancers showing an upward trajectory. This increase is especially alarming due to the growing number of younger individuals being diagnosed with the disease. What makes this trend even more troubling is that regular screenings are a highly effective tool at preventing colon cancer.
The increase in colon cancer cases among younger adults has led the U.S. Preventive Services Task Force to lower the recommended age for colorectal cancer screening from 50 to 45. For those at average risk, it's advised to have a follow-up screening every 10 years if using a colonoscopy. However, the screening interval may be shorter for individuals with significant risk factors, such as a family history of colon cancer, or for those opting for alternative screening methods.
Dr. Jennifer Ayscue is the chief of colorectal surgery for the west region at Orlando Health Bayfront Hospital. For more information, visit bayfronthealth.com
