Colorectal polyps are small growths of tissue that protrude from the wall of the colon or rectum into the gastrointestinal tract. These polyps can be flat, round, or stalk like and may become cancerous. Indeed, most colorectal cancers begin as a polyp. Fortunately, polyps can be detected by colonoscopy and other screening options, and safely removed.
Polyps and early colorectal cancer often cause no symptoms at all, which is why routine screening is important. Symptoms of colorectal cancer may include rectal bleeding or blood in the stool, abdominal discomfort or pain, a change in bowel habits, weight loss, and weakness or fatigue.
For men and women at average risk, screening should begin at age 50 years. People with certain risk factors – such as a personal or family history of colorectal polyps or cancer – should talk with their physician about getting screened at a younger age.
A variety of screening tools are available, including colonoscopy, flexible sigmoidoscopy, double-contrast barium enema, and fecal occult blood test.
Once detected, most polyps can be removed at the time of colonoscopy. Larger polyps may be removed with an innovative combination approach using colonoscopy and laparoscopy, which reduces recovery time over an open surgery and maximizes quality of life.
Individuals with a rare inherited disorder, familial adenomatous polyposis (FAP), develop hundreds to thousands of polyps in their colon often as early as their teenage years and typically develop colon cancer before the age of 40. These polyps increase in number and become cancerous if the colon is not removed. Subtypes of this disorder include attenuated FAP, in which polyps form later in life and typically progress to cancer at the age of 50 years, and autosomal recessive FAP, in which fewer polyps develop that may become cancerous if untreated. Treatment typically involves removal of the colon.
In addition, families with hereditary nonpolyposis colorectal cancer (HNPCC) are at increased risk for developing of colorectal cancer as well as other cancers because they inherit an abnormality in the gene that normally repairs the body's DNA.