What Size Is Considered A Large Polyp?

Facts
- Colon polyp facts
Definition
- What are colon polyps?
Symptoms/Signs
- What are the signs and symptoms of colon polyps?
Pictures
- What do colon polyps look like (pictures)?
Types
- What are the types of colon polyps?
Cancer Risk
- Can colon polyps turn into colon cancer?
- Are the size of colon polyps related to the risk of colon cancer?
Handling
- What procedures and tests diagnose colon polyps?
- Should you get a second opinion after being diagnosed with colon polyps or cancer?
- What is the treatment for colon polyps?
Genetic Testing
- How is genetic testing used in people with colon polyps and colon cancer?
Prevention
- Tin can colon polyps be prevented?
Center
- Colon Polyps: Symptoms, Causes, Cancer Risk, Treatment, & Prevention Center
Comments
- Patient Comments: Colon Polyps - Depict Your Experience
- Patient Comments: Colon Polyps - Treatments
- Patient Comments: Colon Polyps - Diagnosis
- Patient Comments: Colon Polyps - Types
- Patient Comments: Colon Polyps - Symptoms
More
- Find a local Gastroenterologist in your town

Colon polyp facts

Picture of colon polyps.

Colon polyps can turn into colon cancer.

Colon polyps are growths on the inner lining of the colon (large intestine) and are very common.
Colon polyps are important because they may exist, or may get malignant (cancerous). They besides are important considering based on their size, number, and microscopic anatomy (histology); they can predict which patients are more than likely to develop more polyps and colon cancer (colorectal cancer).
Changes in the genetic material of cells lining the colon are the cause of polyps.
In that location are dissimilar types of colon polyps with differing tendencies to become malignant and abilities to predict the evolution of more polyps and cancer. Information technology is important to recognize families with members who accept familial genetic conditions causing polyps because some of these weather condition are associated with a very loftier incidence of colon cancer, and the cancer tin can exist prevented or discovered early on.
Simply a small proportion of polyps cause symptoms or signs. When they exercise, the symptoms and signs usually are the event of bleeding from the polyp and may include
- ruddy blood mixed with stool,
- cherry blood on the surface of stools,
- blackness stools,
- weakness,
- calorie-free-headedness,
- fainting, and
- pale pare.
Colon polyps are diagnosed past endoscopic colonoscopy, virtual colonoscopy, barium enema, and flexible sigmoidoscopy.
Colon polyps are treated past endoscopic removal and occasionally by surgery.
Follow-upwards surveillance of patients with colon polyps depends on the presence of a family history of cancer, the number of polyps that are plant, the size of the polyps, and the polyps' histology, and tin can vary between iii and 10 years.
Treatments to prevent colon polyps are being pursued actively.

Colon and Colorectal Cancer Screening

4 fecal (stool) occult blood tests (FOBT) are tested with;

stool samples,
stool Deoxyribonucleic acid tests,
flexible sigmoidoscopic examinations, and
colonoscopy.

What are colon polyps?

Readers Comments 54
Share Your Story

Colon polyps are growths that occur on the inner lining of the big intestine (colon) and ordinarily beetle into the colon. Polyps class when the genetic material within the cells lining the colon changes and becomes abnormal (mutates).

Normally, the young cells lining the colon are programmed to separate (multiply), mature, and then die in a very consistent and timely fashion. However, the genetic changes that occur in the lining cells forbid the cells from maturing, and the cells do not dice. This leads to an aggregating of immature, genetically aberrant cells, which somewhen results in the formation of polyps. The mutations may occur equally a desultory event after birth or they may be present from earlier nascence.

SLIDESHOW

Colorectal Cancer: Symptoms, Signs, Screening, Stages See Slideshow

What are the signs and symptoms of colon polyps?

Readers Comments 6
Share Your Story

Symptoms

Most colon polyps (95%) do non cause symptoms or signs, and are discovered during screening or surveillance colonoscopy.

When symptoms or signs occur, they may include:

Red claret mixed in with or on the surface of the stool
Black stools if the polyp is bleeding substantially and is located in the proximal colon (cecum and ascending colon)
Iron deficiency anemia if the bleeding has been slow and occurring over a prolonged period of fourth dimension.
Weakness, lite-headedness, fainting, pale skin, and rapid centre charge per unit due to atomic number 26 deficiency anemia
The presence of invisible (occult) claret in stool that is tested when screening for colon cancer at visits to a doctor's office (Considering of the trend of polyps to bleed slowly, intermittently and in small amounts, occult blood testing of stool often is used to screen for colon cancer.)
Rarely diarrhea when large villous polyps secrete fluid into the intestine
Rarely constipation if the polyp is very large and obstructs the colon
Rarely intussusception, a condition in which a polyp drags the portion of the colon to which it is attached into the more than distal colon (i.e., telescopes into the more distal colon) and leads to obstacle of the colon. This tin can crusade all of the signs and symptoms of intestinal obstruction including abdominal pain and distention, nausea and vomiting.

How common are colon polyps?

Colon polyps are very common. They increment in prevalence equally people age; past age 60, i-3rd or more of people volition accept at to the lowest degree 1 polyp. If a person has a colon polyp, he or she is more likely to have additional polyps elsewhere in the colon and is more likely to form new polyps at a later time. In a small subset of patients with colon polyps, in that location is a familial, genetic abnormality that causes patients and other members of their families to develop larger numbers of polyps, to develop them at an early on age, and to more ofttimes have them become cancerous.

Why are colon polyps significant?

Colon polyps are important because they may requite rise to colon cancer (colorectal cancer). The blazon of polyp predicts who is more probable to develop further polyps and colon cancer. Polyps cause other bug (to be discussed), but it is the deadly nature of colon cancer that is of most business organization.

Benign polyps become malignant polyps (cancer) with further mutations and changes in the cells' genetic material (genes). The cells begin to divide and reproduce uncontrollably, sometimes giving rise to a larger polyp. Initially, the increasingly, genetically abnormal cells are limited to the layer of cells that line the inside of the colon. The cells so develop the ability to invade deeper into the wall of the colon. Individual cells also develop the power to break off from the polyp and spread into lymph channels through the wall of the colon to the local lymph nodes and then throughout the body, a process referred to as metastasis although this is unusual unless the cancer has invaded into the wall of the colon.

The transition from benign to malignant polyp can be seen under the microscope. In the earlier phase of the transition, called low-grade dysplasia (dysplasia=abnormal formation), the cells and their relationships to one some other become abnormal. When the cells and their relationships become even more than abnormal, information technology is termed loftier-grade dysplasia. High-grade dysplasia is of greater business organization because the cells are clearly cancerous although they are express to the innermost lining of the colon; with rare exceptions, they take non yet developed the abilities to invade and metastasize (spread to other parts of the trunk). If they are not removed, invasion and metastasis may occur.

Daily Wellness News

Trending on MedicineNet

What do colon polyps look like (pictures)?

Most polyps are protrusions from the lining of the intestine:

Polypoid polyps look like a mushroom, only flop effectually inside the intestine because they are attached to the lining of the colon by a sparse stalk.
Sessile polyps practise non accept a stalk, and are attached to the lining by a broad base.
Flat polyps are the least common type of colon polyp, and are flat or even slightly depressed. These may be difficult to identify because they are non every bit prominent as polypoid or sessile polyps with the normally bachelor methods of diagnosing polyps.

Picture of colon polpys and colon cancer (colorectal).

Picture of colon polyps and colon cancer (colorectal).

QUESTION

Bowel regularity means a bowel movement every day. Run into Reply

What are the types of colon polyps?

Readers Comments 1
Share Your Story

Non all colon polyps are the same. There are different histologic types, that is, the cells that brand up the polyp have dissimilar characteristics when viewed under the microscope. They also vary in size, number, and location. Virtually importantly, they vary in their tendency to become cancerous (malignant).

Adenomatous polyps

The well-nigh common type of polyp is the adenoma or adenomatous polyp. It is an important type of polyp not only considering it is the most mutual, but because information technology is the most common crusade of colon cancer.

The likelihood that an adenoma will develop into (or has already developed into) cancer is partially dependent on its size; the larger the polyp, the more likely it is that the polyp is or will become malignant (concern virtually the malignant potential increases with a polyp greater than 1 centimeter in size).
It as well matters if at that place is a unmarried polyp or multiple polyps. Patients with multiple polyps—even if they are not malignant when examined under the microscope—are more than likely to develop additional polyps in the futurity that may become malignant. Concern well-nigh this increasing malignant potential begins when in that location are three or more than polyps.
Finally, the malignant potential of an adenomatous polyp is related to the manner in which the cells of the polyp organize themselves as seen under the microscope. Cells that organize themselves into tubular structures (tubular adenomas) are less probable to become cancerous than cells that organize themselves into finger-like structures (villous adenomas).

Most adenomatous polyps are considered sporadic, that is, they practice not stem from a recognized genetic mutation that is present at birth (are not familial). Nevertheless, the risk of having colon polyps greater than one centimeter in size or developing colon cancer is two-fold greater if a first degree relative has colon polyps greater than one centimeter in size. Therefore, at that place is likely to be a genetic gene working even in desultory adenomatous polyps.

Genetic adenomatous polyp syndromes

At that place are several familial, genetic conditions in which the mutations or the development of mutations are programmed into an private's genes from earlier birth, passed downwardly from parent to kid.

In the almost common of these weather, hundreds to thousands of adenomatous polyps form (familial adenomatous polyposis or FAP) as a upshot of a mutation in the APC cistron. It is important to recognize these polyposis syndromes and the verbal genetic aberration that causes them, if possible since the malignant potential of these polyps is much greater than that of individuals without the genetic aberration. (Eighty per centum or more of these patients develop colon cancer.) Even though these syndromes are responsible for simply a few per centum of all colon cancers, recognition of a polyposis syndrome identifies patients in whom screening for additional polyps needs to be done more oft and so that new polyps and cancers can exist discovered and treated early on. Information technology may even be recommended that the entire colon be removed to prevent cancer.

In addition, genetic testing can be done for relatives of the patient to decide whether or not the relative has the aforementioned mutation as the patient and, therefore, is very likely to develop polyps and cancer. Relatives with the same mutation then can be screened for the presence of polyps and cancer, preferably starting the colorectal cancer screening at an earlier age than would normally exist done because cancers in these syndromes develop at an earlier age than cancers not associated with a syndrome. Because of the autosomal dominant mode of transmission of the gene and its effects, only one parent needs to take the FAP gene to laissez passer on to his or her children, and therefore, in that location is a 50/50 take chances that each of his or her children will accept FAP.

There is an uncommon form of FAP in which the number of polyps is less than archetype FAP—less than 100—called attenuated FAP. The mutation in the APC gene in attenuated FAP is different than the mutation in classic FAP. Patients with many polyps but non the numbers seen in FAP should exist identified and tested for the mutation. Different FAP, which is an autosomal ascendant syndrome, attenuated FAP is a recessive mutation then that an private needs to inherit i mutated gene from each parent to develop polyps and colon cancer, and because of the rarity of the mutation, this occurs rarely.

Another syndrome of polyps and colon cancer is the MYH polyposis syndrome. Individuals with MYH polyposis develop less than 100 polyps at a immature historic period and are at high risk for developing colon cancer. It is caused by mutations in a unlike gene than FAP, the MYH gene; however, the mutation occurs sporadically due to spontaneous mutations and, therefore, a hereditary pattern is not apparent in parents, although it may be seen in siblings. Because it is an autosomal recessive gene that requires a mutated cistron from each parent, the MYH polyposis syndrome is rare.

Hyperplastic polyps

The second nearly common blazon of colon polyp is the hyperplastic polyp. It is important to recognize these polyps and to differentiate them from adenomatous polyps since they have picayune or no potential to become cancerous unless they are located in the proximal (ascending colon), or evidence a item histologic blueprint under the microscope (a serrated appearance). Nevertheless, there are uncommon genetic syndromes in which patients course many hyperplastic polyps. These patients may exist at a similar risk for developing colon cancer equally patients with multiple adenomatous polyps, particularly if the polyps are large, serrated, located in the ascending colon, and there is a family unit history of colon cancer. Hyperplastic polyps may coexist with adenomatous polyps.

Other types of colon polyps

Much less common types of colon polyps be, and their potential for condign cancerous varies greatly, for instance, hamartomatous, juvenile, and inflammatory polyps.

Subscribe to MedicineNet's General Health Newsletter

Past clicking Submit, I concur to the MedicineNet's Terms & Conditions & Privacy Policy and empathise that I may opt out of MedicineNet'south subscriptions at any time.

Can colon polyps plow into colon cancer?

Although virtually colon cancers ascend from polyps, some practise not. Some arise within the wall of the colon. These cancers may exist flat or fifty-fifty depressed (excavated). They are more difficult to identify and treat, and they are more than likely to spread into the wall of the colon and nearby lymph nodes than cancers originating in polyps. This is particularly true of serrated adenomatous polyps, which normally are flat rather than polypoid in appearance.

In that location also is a familial, genetic syndrome called hereditary nonpolyposis colorectal cancer (HNPCC, Lynch syndrome) in which colon cancers occur with very high incidence (80% or more of patients). At that place are few or no polyps to identify in these patients. Moreover, the cancers occur at a younger age, often prior to the time screening for colon cancer is recommended to begin, and the syndrome is not recognized until a family member develops cancer normally at a young historic period. HNPCC is suspected because other family members too have colon cancer and certain criteria are met (Amsterdam or Bethesda criteria), or the cancer shows a item design under the microscope with special stains. If HNPCC is suspected, genetic testing on the cancer can exist done to identify the hereditary mutation, and other family members can be tested for the same mutation. If nowadays, the family members tin undergo a screening colonoscopy and follow-up surveillance colonoscopies. HNPCC may exist associated with cancers in tissues outside the colon as well. Fortunately, HNPCC is responsible for only a few percentage of all colon cancers.

Are the size of colon polyps related to the risk of colon cancer?

Colon polyps tin vary in size from a few millimeters to several centimeters. The larger the polyp the more than probable it is that there will be cancer inside the polyp or that the polyp will after go cancerous.

From

What procedures and tests diagnose colon polyps?

Readers Comments ten
Share Your Story

There are several means to diagnose colon polyps:

Endoscopic colonoscopy

Endoscopic colonoscopy involves the use of a colonoscope, a flexible tube approximately v anxiety in length with a low-cal and camera at the end and a hollow channel through which instruments can be passed. The colonoscope is passed via the anus into the colon so through the colon until the proximal end of the colon -- the cecum -- is reached. On withdrawal of the colonoscope, the lining of the colon is observed for polyps and other abnormalities. These may be biopsied or removed using electrocautery and so examined under the microscope. Colonoscopy identifies 95% of polyps, small and big, though occasionally polyps are missed if they are small, hidden by folds in the colon'south lining, are flat, or the colonoscopy is hurried.

Virtual colonoscopy

Virtual colonoscopy involves the apply of either computerized tomography (CT) or magnetic resonance imaging (MRI). The colon is filled with either a liquid contrast amanuensis or air, and CT or MRI is performed. Computerized reconstruction of either the CT or MRI images provides a virtual paradigm that mimics the view obtained by a colonoscope. Virtual colonoscopy is very good at finding polyps but not as good as colonoscopy; it tin can miss polyps less than one centimeter in size, although the demand to identify these smaller polyps is debated since they infrequently are cancerous. MRI has an advantage over CT considering information technology does not expose the patient to radiations. It is more expensive, however, and there is less feel with MRI than with CT. The problem with both CT and MRI virtual colonoscopy is that if a polyp is found that should be removed, colonoscopy then must be done at a later time to remove it.

Barium enema

Barium enema is an older method of diagnosing colon polyps. During a barium enema, the colon is filled with barium, and multiple X-rays of the colon are taken as the patient changes position. Barium enema is a good way to diagnose polyps and is relatively inexpensive; however, it can hands miss small-scale polyps and exposes patients to radiation. Moreover, the skills and experience necessary to practise a barium enema properly have declined among radiologists considering barium enemas are less oft ordered at present that colonoscopy and virtual colonoscopy are available. Finally, similar virtual colonoscopy, if polyps are found, a colonoscopy must be done to remove the polyp.

Flexible sigmoidoscopy

Flexible sigmoidoscopy uses a shortened version of a colonoscope, approximately three feet in length. Information technology is able to examine but the distal third to half of the colon. Similar the colonoscope, it can be used to identify, biopsy, and remove polyps without exposure to radiation. For screening purposes, since the sigmoidoscope cannot examine the entire colon, it usually is combined with either less frequent colonoscopy or frequent stool occult blood tests to identify polyps across its reach.

IMAGES

Colon Polyps (Symptoms, Causes, Types, Treatment, Prevention) See a medical illustration of the colon plus our entire medical gallery of man anatomy and physiology See Images

Should you get a second opinion after being diagnosed with colon polyps or cancer?

Several skillful groups have made recommendations for surveillance in individuals who accept been found to have polyps on their initial examination, which usually is endoscopic colonoscopy but occasionally virtual colonoscopy or flexible sigmoidoscopy. The recommendations vary slightly from group to group but not in of import means. They all make recommendations on the basis of factors such as family unit history of polyps and colon cancer, the number of polyps that are found, the size of the polyps, and the polyps' histology.

By using these factors, the interval between surveillance procedures can be tailored to the risk of developing further polyps and malignancy in the future—the college the risk, the shorter the interval between surveillance procedures. The recommendations that follow are modified from the guidelines proposed past the U.S. Multi-Society Task Strength on Colorectal Cancer published in 2012.

2nd examination

If no polyps are establish on the first examination information technology is recommended that a 2nd examination should be washed 10 years later.
If the only polyps that are plant are hyperplastic polyps, and they are limited to the rectum and sigmoid colon and they are all less than one centimeter in size, a second examination is recommended in 10 years.
If i or two tubular adenomas are found and they are less than one centimeter in size, a second examination is recommended in v years though a longer interval may exist reasonable as well.
If 3 to x adenomas are found, it is recommended that a second examination be done in three years.
If more than ten adenomas are found, it is recommended that a second examination be done in 3 years or less.
If i or more tubular adenomas are found that are greater than one centimeter in size, a second examination is recommended in 3 years.
If i or more than adenomas are found of any size and their histology is villous, a second examination is recommended in three years.
If ane or more than adenomas are found and any show loftier grade dysplasia, a 2nd examination is recommended in three years.
If serrated polyps are found, recommendations are less secure because much less data is bachelor about the future risk of polyps and cancers. Concerns are greater (and the interval to the next exam should be shorter) if the polyps are proximal (in the ascending colon), are larger (more than than one centimeter in size), and particularly if they show dysplasia.

Additional examinations

Adenomas can be classified every bit depression risk (LRA) and high risk (HRA) for cancer.

LRA is defined as ane to two tubular adenomas less than one centimeter in size.
HRA is defined as three or more adenomas, with ane tubular adenoma greater than one centimeter in size, or an adenoma with villous histology or loftier-form dysplasia.

Recommendations regarding when to take the tertiary and subsequent examinations depend on the presence of LRA or HRA on the first and second examinations and tin can vary betwixt three and ten years.

What is the treatment for colon polyps?

Readers Comments 15
Share Your Story

Near polyps can be removed through the endoscope. They are then examined under the microscope. It is of import to determine whether or non they comprise cancer, if they are of a type that has cancerous potential, and if they have characteristics that make them more likely to exist associated with cancer, either in some other polyp at the same time or in polyps that may form in the future (for instance, are villous or serrated).

The results of the colonoscopy and histologic exam are important because they decide the need for increased frequency of screening colonoscopy in the future (for example, adenomatous polyps).

If there is cancer already present in the polyp information technology is of import to determine how deep into the wall of the colon the cancer has spread.
If it extends deeply, information technology is more likely that the cancer has spread to lymph nodes farther away. In such cases, information technology may be necessary to do additional endoscopic resection of the area of colon where the polyp was or to surgically remove the department of colon, in society to be certain that all of the cancer has been removed. Nearby lymph nodes too may exist removed and examined to identify any spread of the cancer beyond the colon.
If a genetic mutation is suspected, it is looked for past genetic testing on a portion of the biopsy, and, if present, relatives should exist screened for the same mutation. If present, the relatives should undergo screening colonoscopy and more than frequent surveillance colonoscopy.

It is recommended that patients with FAP and other polyp syndromes consider having their colons removed prophylactically to prevent the development of cancer.

How is genetic testing used in people with colon polyps and colon cancer?

Genetics and genetic testing take go an important aspect in the evaluation of both colon polyps and colon cancer.

Every patient with a colon polyp should accept a careful family history taken. If necessary, individuals or families can be referred to doctors who specialize in the genetics of diseases who can help with decisions about genetic testing and screening. This is peculiarly important in patients with multiple polyps, several family members with polyps or colon cancer, or a family member with early onset of colon cancer (earlier age fifty).

A family history of colon polyps and colon cancer is an of import clue to the possible presence of a familial, genetic syndrome. If a syndrome is suspected, individuals tin can be tested for known mutations, and they can begin surveillance colonoscopies starting at an earlier age; yet, there are still syndromes for which mutations are unknown and for which cannot be tested.

Nevertheless, even in these latter families, there is a benefit; family members are made aware of the possibility of an unidentifiable syndrome and may begin surveillance colonoscopies early. Patients with FAP often have other polyps with malignant potential in the gastrointestinal tract and develop polyps and/or cancers in other gastrointestinal and non-gastrointestinal tissues. They crave further screening to determine if the non-colonic polyps have cancerous potential and if cancer has developed outside of the gastrointestinal tract.

Genetics as well may be used in other ways. In families with FAP or HNPCC, if the genetic aberration is identified in the initial family unit member with polyps or cancer, other family members can be identified with the aforementioned abnormality and who then can begin early colon cancer screening.

Can colon polyps be prevented?

Because of concern regarding the transition of polyps to cancer, attempts have been made to determine if treatments with theoretical potential actually prevent polyps. The problem with most studies is that they are retrospective, observational studies which are not sufficient as proof. The long period of time (many years) that it takes for polyps to grade makes long-term studies mandatory, but such studies have been difficult to practise except in the case of familial, genetic polyposis syndromes, and, because of the differences in their causes, information technology is non clear if what applies to them applies to the more common sporadic adenomas.

Several associations have been explored for antioxidants including selenium, beta carotene, and vitamins A, C, and E. Near of the studies that accept been washed practice not support a part for these agents in preventing polyps or in preventing colon cancer. A limited amount of support is available for the apply of selenium to forbid polyps, but selenium is not recommended for use exterior of experimental trials.
Supplemental dietary calcium has been demonstrated in one study to forestall the formation of polyps. The benefit was seen with supplementation of 1200 mg of calcium per day. At that place is some business organization most using calcium since higher dietary and supplemental levels are associated with an increase in vascular disease. The intake of calcium that was studied was college than the recommended intake of calcium, 800 mg per day.
The all-time back up for a treatment to prevent polyps is with nonsteroidal anti-inflammatory drugs (NSAIDs), a class of drugs that includes aspirin, ibuprofen (Motrin, Advil), celecoxib (Celebrex), and many others. Aspirin has been shown in several studies to reduce the formation of polyps by xxx% to l%. The effect is likely to occur with higher doses of aspirin (more than the 81-325 mg that is recommended for cardiovascular disease prevention), and there is concern about aspirin's side upshot of gastrointestinal bleeding at these doses.
- Celecoxib (Celebrex), a "COX-2 selective NSAID" or Cox-2 inhibitor has been shown to reduce colon polyps xxx% to fifty% every bit well, but in that location is a lingering business organization about the possible cardiovascular side effects that may be seen with well-nigh NSAIDs (though the data supporting this side effect is conflicting). Information technology may be used in patients with genetic polyposis syndromes who choose non to accept their colons removed. Celecoxib might be considered in patients with a low gamble for cardiovascular disease who develop adenomatous polyps frequently.
- Sulindac (Clinoril), a "not-selective NSAID" has been shown to preclude polyps in patients with sporadic adenoma as well as the genetic syndromes. Every bit with celecoxib, there is concern near cardiovascular side furnishings and gastrointestinal ulceration and bleeding.

Given the data that is available, it is not recommended that patients at average risk for the formation of additional polyps be treated for prevention because of concern that the risks of treatment, primarily abdominal haemorrhage and cardiovascular disease, may outweigh the do good of polyp prevention. It may be reasonable to care for patients who are at college than average risk for polyps in which the benefit may outweigh the risks. Such patients might include those with frequent polyp germination, particularly those who take demonstrated cancerous changes in the polyps, or patients who already accept had colon cancer. Studies in these types of patients are eagerly awaited.

Medically Reviewed on 3/xviii/2022

References

Lieberman, D. et. al. "Guidelines for Colonoscopy Surveillance After Screening and Polypectomy: A Consensus Update past the U.s. Multi-Order Job Strength on Colorectal Cancer." Gastroenterology, September 2012; vol. 143: pp 844-857.