Colorectal polyps

Colorectal polyps (adenomas) are predominantly asymptomatic.

Adenomas are highly prevalent and incidence is related to older age, male sex, and family history (first-degree relatives with colorectal cancer).

Most colorectal cancers arise in an adenoma (adenoma-carcinoma sequence).

Colonoscopic polypectomy is diagnostic and therapeutic. Polypectomy reduces the incidence of colorectal cancer by up to 90%.

Surveillance after polypectomy is based upon polyp size, number, and histopathology.

Familial polyposis syndromes should be considered if many polyps are found, particularly in younger patients.

Colorectal polyps are projections arising from the mucosal surface of the colon and rectum. Polyps may be neoplastic or non-neoplastic; histopathology is required to confirm the nature of the polyp. The two main classes of pre-cancerous colorectal polyps are conventional colorectal adenomas and serrated lesions.[1]Rex DK, Boland CR, Dominitz JA, et al. Colorectal cancer screening: recommendations for physicians and patients from the U.S. Multi-Society Task Force On Colorectal Cancer. Am J Gastroenterol. 2017 Jul;112(7):1016-30. https://journals.lww.com/ajg/Fulltext/2017/07000/Colorectal_Cancer_Screening__Recommendations_for.13.aspx http://www.ncbi.nlm.nih.gov/pubmed/28555630?tool=bestpractice.com

This topic covers diagnosis and treatment of sporadic colonic polyps.

See Familial adenomatous polyposis syndromes and Peutz-Jeghers syndrome for the diagnosis and treatment of these hereditary conditions.