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March is Colorectal Cancer Awareness Month. Screening for this cancer is key, as early detection and removal of colon polyps during a colonoscopy can prevent it.

Polyps 101

Kiranpreet Khosa, M.D., of Meritus Digestive Health Specialists, explains that “colon polyps are benign growths in the colon that start from normal colon tissue, but can grow larger and become pre-cancerous.”

“It’s important to know that one in every four women and one in every three men will have a high-risk polyp removed during her/his colonoscopy,” she says.

All polyps do not carry the same risk for colon cancer. The most common type of polyp is the high-risk polyp also known as an adenoma and is often found during a colonoscopy; however, “low-risk, non-pre-cancerous polyps do exist,” says Dr. Khosa.

No Symptoms?

Most often, there are no symptoms when a person has polyps in his/her colon.

“The lack of symptoms is an important reason for everyone to be screened for colon cancer at the recommended age – currently age 50 for those not at high-risk,” says Dr. Khosa. “Discovering that a patient has polyps, how many he/she has and the type of polyps in the colon help determine that individual’s risk for colon cancer.”

A person’s lifetime risk of colon cancer does increase when the adenomas found are high in number. By removing them completely during a colonoscopy, the risk of colon cancer is reduced.

Risks for Adenomas

A family history of colon cancer increases the likelihood of adenomas forming. According to Dr. Khosa, several rare, genetic conditions can also increase a person’s risk.

“A person with either Lynch syndrome, also known as hereditary, non-polyposis colorectal cancer or HNPCC or Familial Adenomatous Polyposis or FAP, both quite rare, has an increased risk of adenomas developing in the colon and his/her physician may recommend a colonoscopy on a more frequent basis to detect and remove any that form,” says Dr. Khosa. Those with the “classic” type of FAP may begin to develop multiple, non-cancerous polyps in the colon as early as their teens.

For the majority of people, high-risk polyps are “spontaneous” and do not involve family history or a genetic condition at all. Dr. Khosa says there are typically lifestyle factors that have increased the risk for this group.

“Tobacco and alcohol use or a diet high in processed or red meat and low in fiber like fruits and vegetables may increase the risk for adenomas,” she says. “But, lifestyle factors can be changed.”

Screening works!

Through effective screening programs that include colonoscopies for early detection and removal of adenomas, colon cancer rates have been decreasing in recent years. While there are other options for screening and detection, the colonoscopy is considered the “gold standard.”

“Colon cancer screening is so important even if you are feeling well,” says Dr. Khosa. “If you have had polyps in the past, it is important to follow up with your providers to find out when you should have another evaluation.”

If the results of your colonoscopy are normal, another one is not necessary for 10 years! Once a person is treated for cancer, follow-up care is essential, which includes recurrence monitoring or surveillance to detect any return of cancer as early as possible.