Identifying Different Types of Colorectal Polyps

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What Are Polyps?

Polyps are small growths of abnormal tissue, found projecting from the inner lining of the colon (large intestine). Polyps can range in size from a few millimeters to several centimeters. Polyps are very common: In fact, an estimated 25 to 40% of Americans over the age of 50 develop colon polyps. While developing polyps is most associated with being 50 and older, other factors are also considered including: having a family history of polyps/colon cancer, being obese, smoking, heavy alcohol consumption, a history of inflammatory bowel diseases, a poor diet, and other environmental factors. 

The vast majority of polyps are harmless, but they can also be precancerous or cancerous in nature. Polyps can take a long time to become cancerous, and are best to be removed upon identification. During a medical exam or colonoscopy, your doctor may identify and remove polyps. Larger or complex polyps are more likely to be cancerous, and can require additional procedures to remove. Colon polyps rarely cause any symptoms, which means scheduling a colorectal screening test is vital for identification.

Identifying Types of Polyps

There are two main categories of polyps: nonneoplastic and neoplastic. Neoplastic polyps are typically precancerous or cancerous, while nonneoplastic polyps are usually benign (non-cancerous). Within these categories, there are many types of polyps. Some of the most common include:

Types of Neoplastic Polyps

  • Adenomatous polyps (Adenoma): The most common type of polyp as well as the most common cause of colon cancer. Structurally, they’re described as tubular, villous, or tubulovillous. Tubular adenoma is less likely to develop into cancer, and makes up 70% of adenomatous polyps. Villous adenoma is flatter and more difficult to remove, and makes up 15% of adenomatous polyps. Tubulovillous is a mix of the two.
  • Serrated polyps: Serrated polyps cause 20-30% of colon cancers. They are divided into two categories: sessile serrated adenoma (SSA) and traditional serrated adenoma (TSA). SSA’s and TSA’s are very rare and almost always precancerous. 

Types of Nonneoplastic Polyps

  • Inflammatory polyps: Typically found in people with Inflammatory Bowel Disease. Usually benign.
  • Hamartomatous polyps: Rare. Usually caused by autosomal disorders. 
  • Hyperplastic polyps: A form of serrated polyp, but are very common and almost always benign. 

Polyp Shapes

Polyps generally grow in three different shapes: pedunculated, sessile, and flat. Pedunculated (polypoid) polyps grow out from the side of the inner lining of the colon like mushrooms, a clump of tissue on a thin stalk. Sessile polyps, on the other hand, do not have a stalk, but rather grow against the side of the colon. The least common shape is a flat polyp. Flat polyps grow completely flat, or depressed into the side of the colon. Sessile and flat polyps are generally more difficult to detect than pedunculated polyps.

Symptoms of Polyps

There are typically no signs of polyps. However, in some rare cases, they can be associated with symptoms such as:

  • Abdominal pain
  • Blood in stool
  • Diarrhea 
  • Constipation
  • Anemia caused by internal bleeding
  • Weakness or tiredness caused by anemia
  • Weight loss
  • Changes in bowel habits
  • Changes in stool color

Diagnosis and Treatment

If you experience any symptoms of colorectal polyps, it’s recommended that you consult a medical professional as soon as possible. Otherwise, most polyps will be diagnosed and treated through a screening test, like a colonoscopy or flexible sigmoidoscopy. In some cases, polyps are too large or complex to be removed immediately and require further surgical procedures.

It’s also important to note that if you have a neoplastic polyp, like an adenoma or a serrated polyp identified and removed during your screening test, you’re still at an increased risk of developing cancer, and will need regular screenings for polyps. The type, amount, and size of the polyps identified will determine how often you need a screening. This can vary from 6 months to 10 years. 

The experienced team at GHP has years of experience treating patients with various GI conditions including colorectal polyps. We can help establish the best plan of care for your situation. Contact any of our office locations to learn about the options we offer and to schedule an appointment today.

 

Importance of Colon Screening in Younger Adults – Dr. Sohi Interviewed

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Dr. Sunana Sohi of Gastroenterology Health Partners was recently featured in a WHAS-11 article and video about the increasing rates of colon cancer in younger adults.

The story featured Amanda Blackburn, a 37 year-old mother of two who was diagnosed with stage 3 colon cancer in 2017. She received a diagnosis after coming to Dr. Sohi with her symptoms of rectal bleeding and a change in bowel habits.

Blackburn had no family history of colon cancer and knew very little about the disease, like many younger adults. “It wasn’t on my radar. The ‘C’ word wasn’t a thing for me,” she said.

Dr. Sohi was able to help Blackburn receive diagnosis and treatment.

“If you have symptoms, don’t wait. There are a lot of tests that can be done, including stool tests, but the number one, the gold standard is colonoscopy. That’s because it’s not only diagnostic but preventative, where we can find and remove small polyps before they become cancer,” Dr. Sohi said.

Read the rest of the Dr. Sohi’s write-up here.

Colon Cancer is not a disease of the elderly anymore; article

 

 

 

 

 

 

 

 

 

 

 

 

 

The article also discussed the upcoming Kicking Butt 5K Run/Walk, scheduled for Saturday September 25th at the Louisville Waterfront Park. This event, sponsored by the Colon Cancer Prevention Project, was started in 2003 as a way to bring together cancer survivors and advocates, spread awareness, and encourage screenings. It’s not too late to sign up for the 5K, 1 mile, or virtual event, and support this worthy cause.

If you or a loved one are experiencing symptoms of colon cancer or another GI condition, don’t hesitate to contact Dr. Sohi or one of the many experienced physicians at Gastroenterology Health Partners.

As the largest independent gastroenterology practice in the region, GHP is considered the only one of its kind providing results-orientated treatment for a full spectrum of digestive system disorders. Call to set up an appointment at one of our locations in Southern Indiana, Northeast & Central Louisville, and Lexington.

Why You Shouldn’t Wait To Get A Colorectal Cancer Screening

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Are you on the fence about getting screened for colorectal cancer? Perhaps you think you’re too young to get cancer, or you don’t have a family history of it, or you’re anxious about the procedure. You push off the appointment, allowing yourself to think, “I’ll do it sometime soon…”

When it comes to colorectal cancer screenings, you shouldn’t ever wait. Regular screenings are recommended for those 45 years and older, and even younger if you have certain risk factors. For example, people with certain inherited conditions are at a higher risk for colon cancer, including those with Lynch syndrome and those with adenomatous polyopsis. You are also at higher risk if you suffer from certain inflammatory bowel diseases like Crohn’s colitis, or ulcerative colitis.

Early detection is the key to effectively dealing with colorectal cancer. When detected early, colorectal cancer has a 95% survival rate. However, that rate drops to 25% if the cancer is not detected and spreads to other organs. 

Screening tests aren’t just used to identify existing cancer. Through screening, your doctor may find and eliminate precancerous polyps (abnormal tissue growths) in the rectum or colon, removing them before they even have the chance of becoming cancerous. Between 25-40% of adults in the United States are estimated to have colorectal polyps.

Colorectal Cancer Increases in Younger Populations 

While the overall occurrence of colorectal cancer has dropped in recent years (largely due to a rise in screenings), its rate among younger populations has actually increased. In fact, according to the American College of Gastroenterology, a millennial now has 2 times the risk of getting colon cancer and 4 times the risk of getting rectal cancer than someone from the baby boom generation. Research shows that rates in adults younger than 50 are continually increasing by 2%, every year. Mortality rates are also increasing.

What is causing this alarming change? Researchers attribute higher colorectal cancer rates in younger adults to a number of factors, including higher rates of obesity, more sedentary lifestyles, poor diet, and other environmental factors. A study released this May found a link between the consumption of sugar-sweetened drinks and colorectal cancer in women under 50. According to the study, women who drank two or more servings of sugary beverages had twice the risk of developing early-onset colorectal than those who consumed less. Furthermore, adolescents ages 13-18 who consumed sugary sodas had a 32% risk of eventually developing early-onset colorectal cancer. Research is only beginning to unlock certain lifestyle and dietary factors that play a role in developing colorectal cancer.

Colorectal Cancer and Covid-19

During the beginning of the Covid-19 pandemic, lockdowns and closings forced many people to cancel or put off every type of screening test. Colorectal screening tests in particular decreased by over 90%. In the following months, the numbers of tests only increased to 50% of what they were before the pandemic began. This drastic decline in testing is associated with troubling data about cancer outcomes. In June 2020, the National Cancer Institute predicted an excess of 10,000 colorectal cancer or breast cancer related deaths in the U.S. over the next 10 years, just because of pandemic-induced delays in testing, diagnoses, and treatments. Remaining up-to-date on testing is more important now than ever. 

If you’re due for a colorectal screening test or appointment, but are concerned about Covid-19 safety, don’t hesitate to book an appointment at Gastroenterology Health Partners. We uphold a number of safety procedures in-office, including mask requirements, cleaning and sanitization practices, disinfecting common spaces, and upholding social distancing when possible. Maintaining your safety is of the highest importance to us, just as is providing you with colorectal screening tests such as colonoscopies, flexible sigmoidoscopies, and more. Give us a call today to schedule your appointment.