A colon polyp is a small growth of cells that develops on the inside lining of the colon. Most polyps are not dangerous. If they’re left untreated, some polyps can turn into colorectal cancer, which can be life-threatening if it is found in later stages.
Colon polyps are very common, affecting 15-40% of adults and becoming more prevalent with age. For adults over 50, about 40% may have polyps. The good news is that most polyps are harmless, and only a small number turn into cancer.
The most common type of polyp that can become cancerous is an adenomatous polyp, or an adenoma. Since adenomas have the highest risk of turning into cancer, doctors usually recommend removing them, which helps prevent the polyp from getting bigger or becoming cancerous.
Anyone can develop colon polyps at any age, but the risk increases as you get older. Your risk also increases if you are overweight, smoke, have had colon polyps before, or have a family history of advanced polyps or colorectal cancer.
Most colon polyps do not cause symptoms, and that is why regular screening is essential. When doctors find polyps early, they can usually remove them safely and thoroughly, making regular screenings the best way to prevent colorectal cancer.
At Charleston GI, we offer board-certified gastroenterologists to examine, diagnose, and treat various GI tract issues including those within your colon to help improve your health. No referral is required to meet with us, so if you’re in the Charleston area, visit any of our four convenient Charleston GI locations.
Open five days a week, we’re committed to a higher standard of care and provide a range of medical treatments to help you feel your best.
Colon polyps are classified into two main groups: nonneoplastic and neoplastic. Nonneoplastic polyps are noncancerous, meaning they usually do not turn into cancer. Neoplastic polyps are precancerous, meaning they can progress into cancer if not removed.
Noncancerous Polyps (Nonneoplastic)
Hyperplastic polyps: Very common, most often found in the lower colon and rectum. They are small and rarely turn into cancer.
Inflammatory polyps (pseudopolyps): Often occur in individuals with Crohn's disease or ulcerative colitis. They do not become cancerous, but they show long-term inflammation.
Hamartomatous polyps: Made of normal tissue that grows abnormally. In children, a single polyp is usually harmless and goes away without intervention. Multiple polyps, or polyps linked to genetic conditions like Peutz-Jeghers or Cowden syndrome, can increase cancer risk.
Precancerous Polyps (Neoplastic)
Adenomas (Adenomatous Polyps):
Tubular adenomas: Most common type, lowest cancer risk.
Tubulovillous adenomas: Mix of tubular and villous features. Moderate risk of cancer development.
Villous adenomas: The rarest kind but the highest risk, especially when large.
Serrated Polyps:
Sessile serrated lesions (SSLs): Flat, often occur in the right colon. Difficult to detect and can become cancerous if large or irregular.
Traditional serrated adenomas (TSAs): Rare, usually found in the left colon. Always considered precancerous and are removed when found.
CAUSE
At this point, experts have not found a clear cause of colon polyps.
What we do know is that polyps occur when the normal process of cell growth and repair in the colon goes wrong. Typically, the body replaces old cells with new cells in an orderly manner. However, when this process goes awry, it causes the body to make too many cells. Over time, these extra cells build up and form a small growth on the intestinal lining called a polyp.
Polyps can grow anywhere in the large intestine, including the colon and the rectum. When a polyp grows in the rectum, it’s called a rectal polyp. Since the rectum is the lower part of the colon, rectal polyps are categorized as a type of colon polyp.
In many cases, colorectal cancer begins when one of these polyps remains in the body for years. As a result, the larger a precancerous polyp becomes, the higher the chance that it may turn into cancer.
RISK FACTORS
Age and Medical History
Being 45 years of age or older
Inflammatory bowel disease (IBD), including ulcerative colitis or Crohn’s disease
In the United States, Black individuals have a higher risk of colorectal cancer.
It’s important to note that risk increases with age, family history, and certain health conditions. Your lifestyle choices, like diet, exercise, smoking, and alcohol use, play a significant role.
SYMPTOMS
Most people with colon polyps don’t experience any symptoms. Colon polyps are most likely to be identified during a routine colorectal cancer screening, which is why these screening tests are essential to your health.
Symptoms that should prompt an appointment with a gastroenterologist include:
Bowel Changes
Constipation or diarrhea continuing for than one week
Ongoing changes in bowel habits
Changes in Stool
Blood in stool, red streaks, or black stools
Unusual or persistent color changes
Mucus in Stool
Increased or noticeable mucus
More importantly, if it appears alongside other symptoms
May be caused by polyps, cancer, or other conditions
Remember, colon polyps often cause no symptoms, so don’t ignore ongoing bowel changes, bleeding, or pain. Schedule your routine screening with Charleston GI to help catch polyps early.
CONDITIONS LINKED TO COLON POLYPS
Both hereditary gene changes and non-genetic reasons can cause some colon polyps. These can include:
Inherited Polyp Conditions
Lynch Syndrome
Experience few polyps, but are at a higher risk of becoming cancerous
Most common inherited risk of colon cancer
Also linked to cancers of the stomach, uterus, bladder, and skin
Greater concern if family members had cancer before age 50
Regular screening helps lower cancer risk
Familial Adenomatous Polyposis (FAP)
Causes hundreds or thousands of polyps at a young age
Nearly 100% risk of colon cancer if left untreated
Cancer often develops before age 40
Managed with frequent screening and, in some cases, colon removal surgery
Genetic testing can confirm risk
MUTYH-Associated Polyposis (MAP)
Similar to FAP
Causes multiple polyps and early colon cancer
Linked to MUTYH gene changes
Genetic testing helps identify risk
Peutz-Jeghers Syndrome
Causes freckles on the lips, mouth, and skin
Leads to noncancerous polyps throughout the intestines
Higher lifetime risk of colon cancer
Juvenile Polyposis Syndrome (JPS)
Usually affects children, but can occur in adults
Often involves one polyp, but multiple polyps increase cancer risk
Non-Inherited Condition
Serrated Polyposis Syndrome
Usually not inherited
Diagnosed based on having many serrated polyps
Polyps can become cancerous
Requires more frequent colonoscopies and polyp removal
Whether your risk is related to a non-inherited or inherited condition, early screening is critical, so be sure to maintain a regular screening schedule to help lower your risk of colorectal cancer.
You are under 45 and have an increased risk due to:
Family history of colorectal cancer
Certain medical conditions
If you have ongoing symptoms, don’t ignore them. See a doctor as soon as possible if you experience any of the above-mentioned symptoms. Our team at Charleston GI can provide regular screenings to help you find problems early, even before you notice any symptoms.
DIAGNOSTIC TEST
For diagnosing colon polyps, a colonoscopy is the most comprehensive test for detecting polyps. Other tests can help screen, but a colonoscopy will likely be required if results are abnormal.
Allows real-time viewing on a screen in the procedure room
Polyps can be removed or biopsied during the procedure
Other abnormal areas can also be sampled
Virtual Colonoscopy
Uses a CT scan to view the colon
Requires the same bowel prep as a colonoscopy
If polyps are found, a standard colonoscopy is still needed to remove them
Flexible Sigmoidoscopy
Uses a camera to examine the lower third of the colon
Does not view the entire colon
May miss some polyps or cancers
Often repeated more frequently or combined with yearly stool tests
Stool-Based Tests
Tests for blood in the stool, completed annually
Some tests also check for tumor markers and are completed every three years
A positive result requires a follow-up colonoscopy
Blood-Based Test
FDA-approved blood test for colon cancer
Repeated every three years
A positive result requires a follow-up colonoscopy
TREATMENT
If your gastroenterologist finds polyps during a bowel exam, they’ll most likely remove them right away. There are a few different methods for removing polyps depending on their size and type.
Polyp Removal During Colonoscopy
Tiny polyps are removed with forceps
Small to medium polyps are removed with a wire loop called a snare
Doctors may use a mild electric current to cut the polyp and stop bleeding
Removing polyps this way helps prevent colorectal cancer
Minimally Invasive Surgery
Method used for large polyps or polyps that cannot be safely removed during a colonoscopy
Uses a thin tube called a laparoscope to remove part of the bowel.
Total Proctocolectomy
Less common surgery, typically done for inherited conditions like FAP
It removes the entire colon and rectum.
It protects against colorectal cancer in people with a very high risk
Polyp Analysis
After removal, a pathologist looks at the polyp under a microscope.
This shows the type of polyp and the risk of cancer.
Most polyps are safely removed during a colonoscopy. Typically, surgery is necessary only for large polyps or for people with certain high-risk conditions. Most doctors will complete a tissue analysis to help plan the next steps in care.
PREVENTION
Regular screenings can help significantly lower your risk of colorectal cancer and tackle colon polyps early on. In addition to routine screenings, specific lifestyle changes can help protect your colon.
Adopt healthy habits:
Eat plenty of fruits, vegetables, and whole grains
Limit high-fat foods
Reduce alcohol and quit all tobacco use
Stay active and maintain a healthy body weight
Take extra precautions if:
You have a family history of colon polyps
You have had 10 or more precancerous polyps
You have a hereditary disorder that causes colon polyps
Depending on your family history, your doctor may refer you to a genetic counselor.
Colon Polyps Diet and Lifestyle Guide
Foods and Drinks to Avoid
Meats
Red meat, like beef and pork
Processed meats like bacon, sausage, hot dogs, and deli meats
No. Colon polyps do not indicate cancer. Some polyps can become cancerous over time, but many do not. Doctors remove polyps during a colonoscopy to prevent problems before they start.
Will colon polyps go away on their own?
Usually not. Most colon polyps remain in the colon unless a doctor removes them. Some tiny polyps might be harmless, but others can turn into cancer. Removing them during a colonoscopy helps keep you safe.
Can genetics cause colon polyps?
Yes. If close family members have had colon polyps, you are more likely to get them. Some rare inherited syndromes can also cause polyps, including:
Familial adenomatous polyposis (FAP)
Peutz-Jeghers syndrome
MUTYH-associated polyposis
Gardner syndrome
PTEN hamartoma tumor syndrome
Turcot syndrome
Serrated polyposis syndrome
Juvenile polyposis syndrome
Can the environment cause colon polyps?
Yes. Aspects of your daily life can increase risk, such as:
Getting older
Smoking
Drinking too much alcohol
Eating a high-fat, low-fiber diet
Not exercising enough
Being overweight
Having diabetes
Inflammatory bowel disease (like Crohn’s or ulcerative colitis)
Some people with chronic inflammation in the colon may develop bumps called “pseudopolyps” that develop after ulcers heal. These are not true polyps. However, they may also result from lifestyle factors that lead to recurrent ulcers.
How common are colon polyps?
Colon polyps are common. About 20% of adults get them, 40% of people over 50 may have them, and about 6% of children get them, too. Everyone is at risk, regardless of gender or background.
What percentage of colon polyps are cancerous?
Most polyps could become cancer, but few actually do. About 5% of adenomas (the most common type) become cancerous. It usually takes many years. Removing polyps early helps prevent cancer.
How long before colon polyps become cancer?
Colon polyps usually take 10-15 years to turn into cancer. Many never become cancerous. Larger polyps or adenomas are more likely to cause problems.
What are common complications of colon polyps?
The primary risk is that some polyps can turn into cancer. Removing them early reduces this risk.
How many polyps are normal in a colonoscopy?
It’s normal to have zero or a few polyps. Doctors look at the number, size, type, and location of polyps. More than three polyps, polyps larger than 10 mm, or certain types may increase the risk of cancer.
What causes colon polyps?
Genetic mutations most often cause colon polyps. These can be inherited from family or happen randomly. Environmental factors, like diet and lifestyle, can also contribute.
How can I stop polyps from growing?
Healthy habits can assist in lowering your risk of polyps, including:
Eat more fiber (fruits, veggies, whole grains)
Eat less red or processed meat
Don’t smoke and limit alcohol
Exercise regularly
Keep a healthy weight
Get enough calcium and vitamin D
Ask your doctor about aspirin if you’re at high risk
Even with a healthy lifestyle, colonoscopies are the most effective way to detect and remove polyps.
What does follow-up look like after treatment?
Follow-up treatment depends on the number and size of polyps:
1-2 small polyps → next colonoscopy in 7-10 years
3-4 polyps → in 3-5 years
5-10 polyps or large polyps → in 3 years
More than 10 or very large polyps → in 6-12 months
What is a colonoscopy?
A colonoscopy is a procedure in which a doctor looks inside your large intestine with a camera on a long, flexible tube. They can remove polyps and take tissue samples if needed. You are typically sedated for your comfort.
Can a doctor tell if a polyp is cancerous during a colonoscopy?
No. The doctor cannot be sure just by looking. The polyp must be removed and sent to a lab for a biopsy. The lab tells if it is benign (noncancerous), precancerous, or cancerous.
How often should I have a colonoscopy if polyps are found?
The frequency with which you need colonoscopies depends on your risk:
People with inflammatory bowel disease → every 1-3 years
People with specific genetic syndromes → may need colonoscopies starting as teens, more often
Your doctor will determine the best schedule for your needs based on your history and findings.
How do I prepare for a colonoscopy?
For a colonoscopy, your colon must be completely cleaned out. Stool can obstruct your doctor’s view and affect their findings. Follow instructions for bowel prep carefully. Tell your doctor about medicines that affect bleeding, as they may give guidance on how to take them safely.
What is a biopsy?
A biopsy is when your doctor takes a tiny piece of tissue to examine under a microscope. A biopsy provides further diagnostic information and helps determine whether cells are normal, precancerous, or cancerous.
How long does it take to get colon polyp biopsy results?
Usually 1-2 weeks, sometimes up to 3-4 weeks. Your doctor will contact you with the results and next steps.
What if a polyp biopsy shows cancer?
Your doctor will make a treatment plan. Treatment may include surgery, chemotherapy, or radiation therapy, depending on the cancer type.
SCHEDULE YOUR GI APPOINTMENT TODAY, NO REFERRAL NEEDED
To learn more about your risk of colon polyps and the regular screening process, get in touch with our team at Charleston GI today. We’re dedicated to providing a higher standard of caring, delivering a range of treatment options to help you feel your best and get to the bottom of your GI tract issues.
Medical Disclaimer: This page is for general educational purposes only and is not medical advice. It does not replace evaluation or care from a licensed healthcare provider. Screening recommendations and results vary by individual. Viewing this page does not create a doctor-patient relationship.
A colon polyp is a small growth of cells that develops on the inside lining of the colon. Most polyps are not dangerous. If they’re left untreated, some polyps can turn into colorectal cancer, which can be life-threatening if it is found in later stages.
