Thank you for providing an answer in advance, it is appreciated. I am a 34 year old male with a few colon problems. After having pain in my left lower belly, and some rectal bleeding I had a barium Xray in which the doc discovered scattered diverculum. Last week I had a flexible signoscopy and the doc found a small polyp and removed it. I am scheduled for a colonoscopy shortly. My question how common is it for a young person like myself to have colon polyps? And does the earlier the age that polyps are found mean anything as far as cancer percentages? Will I have more of a chance of developing more polyps? How often should I have a colonscopy done on a regular basis? If the doctor says that the polyp is non cancerous then why do they send it away for testing? Thanks again for your reply.
A colon polyp is tissue that protrudes into the bowel lumen. A polyp can be
made of different types of cells. Examples of benign polyps without malignant potential are hyperplastic, lipomas, and inflammatory polyps. These types of polyps do not require follow-up colonoscopy and do not mandate colon cancer screening
The polyps with malignant potential are called adenomas . These form a small proportion of all colonic polyps. Doctors remove adenomas because some of them may progress to colon cancer.
It is difficult to tell by external appearance whether a polyp is an adenoma. The diagnosis is made by microscopic appearance. The majority of adenomas are benign and the very act of removing them during colonoscopy is sufficient to eliminate the risk of cancer developing in that polyp. Only a very small number of cases need surgery.
Now let's try to answer some of your questions. We would like to emphasize to you that the following information is only about adenomas.
1) How common is it for a young person (34 Y) to have colon polyps?
The prevalence of adenomas is affected by two factors: the inherent risk for colon cancer in a population and the age of the subjects. Different ethnic groups have different risks of developing colon cancer. For example as many as 50% of Hawaiian-Japanese males in the age group of 20-39 may have polyps. Studies have indicated that in low risk populations about 10% of people have adenomas
In all ethnic groups, the frequency of polyps increases with age. In general, 90% of colon cancers occur in persons older than 50 years. The majority of these cancers arise from adenomas. Since it takes approximately 8-10 years for an adenoma to progress into cancer, it would be reasonable to assume that polyps start appearing around the age of 40-45 and the number of people with polyps increases with advancing age..
In order to guess at the significance of your polyp we would need to know 1) whether you belong to a high risk ethnic group, 2) whether your family history increases the risk of cancer (see response to Robin regarding colon cancer) and 3) whether your polyp is an adenoma.
2) Does age of diagnosis of polyps translate into cancer percentages?
There is a higher incidence of colon cancer in patients who have multiple adenomas at an earlier age. Other risk factors are certain familial syndromes, inflammatory bowel disease, family history of colon cancer. These patients usually belong to a high risk group and are identified by their medical history and clinical features.
3) Will I have a chance of developing more polyps?
Yes. You may have a chance of developing more polyps. However, the extent of this chance depends on the factors described above.
4) How frequently should colonoscopy be done?
The answer to this question depends on the number and microscopic features of the polyps removed. The recommendations regarding the frequency of screening are constantly being reevaluated and changes may be presented in the future. If your doctor finds a few adenomas and removes them all , then you will need a repeat colonoscopy in 3 years. After that you may need a colonoscopy every five years. The frequency and duration of the screening program will depend on whether you are thought to be at increased risk of developing colon cancer. On the other hand if your doctor finds benign polyps such as hyperplastic polyps, a lipoma , a hamartoma etc you will not need future colonoscopies and can be followed by annual checking of your stool for blood and sigmoidoscopy every three years.
5) Why does a polyp need to be sent for testing?
All polyps must be sent for microscopic examination. It is not possible to comment on the nature of a polyp by external appearance
We hope we have been able to answer some of your questions. These are general answers and only your doctor who knows your medical history can help guide your future care.
If you would like to be seen at our institution please call 1-800-653-6568, our Referring Physicians' Office and make an appointment to see Dr. Bresalier, one of our experts in the area of colon cancer. He would be happy to see you at and provide more information regarding coon cancer/polyps as well as ongoing care if this would be helpful to you.
*keywords: colon cancer, polyps, colonoscopy, hereditary nonpolyposis syndromes
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