Colorectal polyps

Definition

A colorectal polyp is a growth on the lining of the colon or rectum.

Alternative Names

Intestinal polyps; Polyps - colorectal; Adenomatous polyps; Hyperplastic polyps; Villous adenomas; Serrated polyp; Serrated adenoma; Precancerous polyps; Colon cancer - polyps; Bleeding - colorectal polyps

Causes

Polyps of the colon and rectum are most often benign. This means they are not a cancer. You may have one or many polyps. They become more common with age. There are many types of polyps.

Adenomatous polyps are a common type. They are gland-like growths that develop on the mucous membrane that lines the large intestine. They are also called adenomas and are most often one of the following:

When adenomas become cancerous, they are known as adenocarcinomas. Adenocarcinomas are cancers that originate in glandular tissue cells. Adenocarcinoma is the most common type of colorectal cancer.

Other types of polyps are:

Polyps that are 1 centimeter (cm) or larger have a higher cancer risk than polyps smaller than 1 cm. Risk factors include:

A small number of people with polyps may also be linked to some inherited disorders, including:

Symptoms

Polyps usually do not have symptoms. When present, symptoms may include:

Exams and Tests

Your health care provider will perform a physical exam. A large polyp in the rectum may be felt during a rectal exam.

Most polyps are found with the following tests:

Treatment

Colorectal polyps should be removed because some can develop into cancer. In most cases, the polyps may be removed during a colonoscopy.

For people with adenomatous polyps, new polyps can appear in the future. You should have a repeat colonoscopy, usually 1 to 10 years later, depending on:

In rare cases, when polyps are very likely to turn into cancer or too large to remove during colonoscopy, the provider will recommend a partial colectomy. This is surgery to remove part of the colon that has the polyps.

Outlook (Prognosis)

The outlook is excellent if the polyps are removed. Polyps that are not removed can develop into cancer over time.

When to Contact a Medical Professional

Contact your provider if you have:

Prevention

To reduce your risk of developing polyps:

Your provider can order a colonoscopy or other screening tests:

Taking aspirin, naproxen, ibuprofen, or similar medicines may help reduce the risk for new polyps. Be aware that these medicines can have serious side effects if taken for a long time. Side effects include bleeding in the stomach or colon and heart disease. Talk with your provider before taking these medicines.

References

Centers for Disease Control and Prevention. What can I do to reduce my risk of colorectal cancer? www.cdc.gov/cancer/colorectal/basic_info/prevention.htm. Updated February 23, 2023. Accessed February 11, 2024.

Garber JJ, Chung DC. Colonic polyps and polyposis syndromes. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 126.

National Cancer Institute website. Colorectal cancer prevention (PDQ) - health professional version. www.cancer.gov/types/colorectal/hp/colorectal-prevention-pdq. Updated August 18, 2023. Accessed February 11, 2024.

National Comprehensive Cancer Network website. NCCN clinical practice guidelines in oncology (NCCN guidelines): colorectal cancer screening. Version 1.2023 - May 17, 2023. www.nccn.org/professionals/physician_gls/pdf/colorectal_screening.pdf. Updated May 17, 2023. Accessed February 11, 2024.

Patel SG, May FP, Anderson JC, et al. Updates on age to start and stop colorectal cancer screening: recommendations from the U.S. Multi-Society Task Force on Colorectal Cancer. Gastrointest Endosc. 2022;95(1):1-15. PMID: 34794803 pubmed.ncbi.nlm.nih.gov/34794803/.

Qaseem A, Crandall CJ, Mustafa RA, Hicks LA, Wilt TJ. Clinical Guidelines Committee of the American College of Physicians, et al. Screening for colorectal cancer in asymptomatic average-risk adults: a guidance statement from the American College of Physicians. Ann Intern Med. 2019;171(9):643-654. PMID: 31683290 pubmed.ncbi.nlm.nih.gov/31683290/.

US Preventive Services Task Force website. Final recommendation statement. Colorectal cancer: screening. www.uspreventiveservicestaskforce.org/uspstf/recommendation/colorectal-cancer-screening. Published May 18, 2021. Accessed February 11, 2024.


Review Date: 5/2/2023
Reviewed By: Michael M. Phillips, MD, Emeritus Professor of Medicine, The George Washington University School of Medicine, Washington, DC. Internal review and update on 02/10/2024 by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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