Colonic Polyps and Cancer

Colonic Polyps and Cancer

Colonic polyp

A polyp is a discrete tissue mass that protrudes into the lumen of the bowel.

Polyps are categorized into neoplastic polyps and non-neoplastic polyps

Neoplastic polyps

  • Adenoma

Non-neoplastic polyps

  • Hyperplastic polyps
  • Inflammatory polyps
  • Juvenile polyps
  • Peutz Jeghers polyps


Adenomas are benign polyps, categorized into two types, tubular and villous adenomas.

Polyps > 2 cms, and those with villous structural morphology have a higher possibility to transform to malignancy.

Polyps <5 mm are known as diminutive polyps. Polyps have no potential to transform into malignancy.

Risk factors

  • Inherited susceptibility
  • Excessive dietary intake of low fiber and fat

Clinical features

Most of the polyps are asymptomatic

  • Abdominal pain
  • Rectal bleeding
  • Diarrhea
  • Constipation
  • Colonic obstruction


  • Colonoscopy is indicated for diagnosing polyps


  • Adenomas that do not encroach deeper layers require endoscopic management.
  • Resected polyp should undergo histopathologic examination to confirm the complete resection
  • A polyp that invades deeper layers should be managed surgically

Colon cancer

Colon cancer is a major factor for morbidity and mortality

Risk factors

  • High fat low fiber diet
  • Smoking
  • Colorectal adenomas polyposis syndromes
  • Family history of colorectal cancer
  • Ulcerative colitis
  • Crohn’s disease


  • Tumors that are present on the right side of the colon have a large size. It presents as chronic bleeding in addition to a palpable mass.
  • Tumors that are present on the left side of the colon have different clinical manifestations such as changes in bowel habits, anemia, abdominal pain, and chronic bleeding.


  • Colonoscopy helps in confirmation of diagnosis
  • Biopsy identifies suspected growth based on the histopathological confirmation


  • CECT abdomen determines distant metastasis


  • Surgery is the main treatment modality for colon cancer
  • Patients with advanced disease (such as disease extending beyond serosa, liver metastasis) are recommended chemotherapy
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