Are Colon Polyps Always a Sign of Colorectal Cancer?

If you’ve ever had a colonoscopy or known someone who has, you may have heard about “colon polyps” being removed during the procedure. What are colon polyps — and why do they matter?

“Polyps are abnormal growths that can develop in different parts of the body, such as the colon and rectum,” says Dr. Richard Stewart, a gastroenterologist with Beaufort Memorial Lowcountry Medical Group Specialty Care. “Some polyps within the colon and rectum can be precancerous, so removing them during a colonoscopy can eliminate the risk of them turning into cancer.” 

A colonoscopy is one tool used to prevent colorectal cancer from developing in the first place and to detect it in an early stage when it’s most easily treatable.

When Colon Polyps Pop Up

Colon polyps develop on the colon, the longest portion of the large intestine. Adenomatous polyps, also called adenomas, are the most common type of colon polyp, appearing as a gland-like growth on the mucous membrane of the colon. 

Along with being the most common type of polyp, adenomas are also the most likely to develop into cancer. Other types of colon polyps, including hyperplastic polyps, inflammatory polyps and hamartomatous polyps, are not associated with cancer.

In general, large polyps — the width of a pencil or bigger — are more likely to have precancerous cells or to be cancerous. Any adenoma, however, can turn into cancer, so removal is recommended.

“Colon polyps are removed during a colonoscopy because nearly all cases of colorectal cancer begin as a polyp,” Dr. Stewart says. “Removing them can stop cancer before it even starts.”

Read More: How to Make Your Colonoscopy Prep Drink Easier to Stomach

Why Colorectal Cancer Screenings Are Important

It’s rare to experience symptoms from a colon polyp, although they can cause rectal bleeding in some cases.  

That’s why regular colorectal cancer screenings are recommended. These screening tests can help detect the presence of polyps or colorectal cancer long before symptoms develop.

The U.S. Preventive Services Task Force recommends that adults at average risk for colorectal cancer begin screening at age 45, continuing until age 75. Those who are at a higher risk may need to begin screening at an earlier age or to have more frequent screenings. Risk factors for colorectal cancer include:

• A family history or personal history of rectal or colon cancer or polyps
• Genetic syndromes such as Lynch syndrome or familial adenomatous polyposis syndrome
• Inflammatory bowel disease such as ulcerative colitis or Crohn’s disease

If you’re due for a colorectal cancer screening, your primary care provider can recommend the screening that will work best for you. While a colonoscopy is the only screening method that can detect and remove polyps in the entire colon and the rectum, other screening tests can help detect colorectal cancer.

• Stool tests detect blood in the stool, which can be an indicator of colorectal cancer. The FIT-DNA test detects altered DNA in the stool along with blood. Standard stool tests are repeated each year, while the FIT-DNA test is repeated every three years.
• Flexible sigmoidoscopy works similarly to colonoscopy in detecting and removing polyps but only examines the rectum and the lower part of the colon. This test is repeated every five years or every 10 years when paired with an annual stool test.
• Virtual colonoscopy uses computed tomography (CT) scans to capture images of the entire colon. While this test can visualize the colon, it doesn’t allow for the removal of polyps during the procedure. This test is repeated every five years.

If screening tests other than colonoscopy identify cancer, they’re usually followed by a colonoscopy.

Read More: Is Colon Cancer Hereditary? Know Your Risk and What to Do About It

What You Can Do to Lower Your Risk

While there’s no foolproof strategy for preventing polyps or colorectal cancer, you can take steps to lower your risk. Many factors that increase the risk of developing colon polyps, such as your age and family medical history, aren’t things you can control.

Two of the known risk factors, though, are within your control. Colon polyps are more common among those who have obesity and those who smoke, so you can lower your risk of polyps by losing weight and quitting smoking.

Those two changes will also help you lower your risk of developing colorectal cancer. Other habits that can help prevent colorectal cancer include:

• Avoiding or minimizing alcohol consumption
• Being physically active and increasing the intensity of your workouts
• Eating a diet filled with fruits, vegetables and whole grains
• Limiting your intake of red and processed meats 

If you have risk factors for colorectal cancer, talk with your primary care provider about other steps you can take to protect your health. Identify when and how often you should undergo colorectal cancer screening, including colonoscopy. 

Your provider may also recommend other preventive measures, such as taking aspirin daily, which has been shown to reduce the risk of both cancer and cancer death, or eating a plant-based diet that avoids animal fats. 

The list above isn’t all-inclusive. Healthy habits in general can help you protect your overall health — and your colon health, lowering your risk of polyps and cancer.

Talk with your primary care provider about colon cancer screenings that may be right for you. Don’t have a provider? Find one in our provider directory.