Certain types of polyps may warrant keeping closer tabs on the colon

Being on the lookout for certain features of polyps may help physicians keep a closer eye on patients at risk for colorectal cancer.

Starting at age 50, or earlier with certain risk factors, patients are advised to be screened for colon cancer at regular intervals. Colonoscopy is an effective screening test because it allows doctors to find and view individual polyps (growths), and to remove them before they become cancerous.

Adenomas are polyps (small growths in the lining of the colon) that can vary in their size and shape, but are potentially precursors to colon cancer. Removal of these polyps reduces the risk of colon cancer. Flat adenomas are precancerous polyps that do not have a typical polyp- like appearance during endoscopy.

A new study in GIE: Gastrointestinal Endoscopy, the journal of the American Society for Gastrointestinal Endoscopy (ASGE), "Prevalence of advanced histological features and synchronous neoplasia in patients with flat adenomas," indicates that a patient who had at least one flat adenoma had a higher chance of having multiple lesions with more advanced changes.

The researchers looked at data from three clinical trials conducted at two medical centers that included patients undergoing screening or surveillance colonoscopy. The location, size, form and structure of each removed polyp was documented and sent for microscopic examination.

Risk Factors for Colorectal Cancer

The exact cause of colorectal cancer is not known, there are some factors that increase a person's risk of developing the disease. These include:

• Age. The risk of developing colorectal cancer increases with age. The disease is most common in people over age 50, and the chance of getting colorectal cancer increases with each decade. However, colorectal cancer can develop in younger people.
• Gender. The risk overall is equal, but women have a higher risk for colon cancer, while men are more likely to develop rectal cancer.
• Polyps. Polyps are non-cancerous growths on the inner wall of the colon or rectum. While they are fairly common in people over age 50, one type of polyp, referred to as an adenoma, increases the risk of developing colorectal cancer. Adenomas are non-cancerous polyps that are considered precursors, or the first step toward colon and rectal cancer.
• Personal history. Research shows that women who have a history of ovarian, uterine, or breast cancer have a somewhat higher risk of developing colorectal cancer. A person who already has had colorectal cancer may develop the disease a second time, especially if the first disease was diagnosed before age 60. In addition, people who have chronic inflammatory conditions of the colon, such as ulcerative colitis or Crohn's disease, are at higher risk of developing colorectal cancer.