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Digestive Diseases

Colorectal Polyps

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• Symptoms and Screening for Colorectal Polyps
• Treatment for Colorectal Polyps
• Heredity and Colorectal Polyps
• Research for Colorectal Polyps
• Contact Information

Colorectal polyps are small growths of tissue that protrude out from the wall of the colon or rectum into the gastrointestinal tract. These polyps can be flat, round, or stalk like. Polyps can develop anywhere in the colon or rectum and can be detected by colonoscopy or another testing option. Some polyps may become malignant. Indeed, most colorectal cancers begin as a polyp.

Polyps and early cancers often cause no symptoms at all, which is why routine colorectal screening is important. Often, polyps can be detected and removed before cancer develops.

For men and women at average risk, colorectal cancer screening should begin at age 50. Recommended screening options include colonoscopy every 10 years, OR flexible sigmoidoscopy every 5 years, OR double-contrast barium enema every 5 years, or CT colonography every 5 years, OR fecal occult blood test or fecal immunochemistry test every year OR DNA stool testing (unknown interval). Men and women with certain risk factors – such as a personal or family history of colorectal polyps or cancer – need to talk with their doctor about getting screened at a younger age. If any of the screening options show polyps or a positive result (abnormal), a follow-up colonoscopy is needed.

Once detected, most polyps can be removed at the time of colonoscopy. However, some polyps may be too large to be removed during a colonoscopy. In these cases, an innovative combination approach utilizing colonoscopy and laparoscopy allows for the removal of many of these polyps without open surgery, thereby reducing recovery time and maximizing quality of life.

Individuals with a rare inherited disorder, familial adenomatous polyposis, or FAP, develop multiple polyps in their colon often as young as their teenage years. These polyps increase in number and become cancerous if the colon is not removed. On average, individuals with FAP develop colon cancer around age 39.

In a variation on this disease, called attenuated familial adenomatous polyposis, individuals develop polyps at a later age, and the average age of cancer diagnosis is 55. There is also a milder form of FAP, called autosomal recessive familial adenomatous polyposis, in which individuals develop fewer polyps, which later become cancerous.

Another hereditary form of colorectal cancer is called hereditary nonpolyposis colorectal cancer (HNPCC). In this condition, colorectal cancer risk is increased in families due to a genetic predisposition to form polyps at a young age. In addition to colorectal cancer, families with this condition may be at increased risk for other cancers such as uterine cancer, ovarian, and gastric cancers.

The Jay Monahan Center for Gastrointestinal Health at NewYork-Presbyterian Hospital/Weill Cornell Medical Center has major efforts underway focusing on the screening, prevention, and early detection of colorectal cancer. In addition, research is ongoing to determine agents or medications that may reduce the risk of polyp development and to improve technologies for the detection of colorectal polyps, cancers, and other conditions.