Colon polyps are small growths or bumps that form on the lining of the large intestine or rectum. Most look like bumps of various sizes (sessile polyps), but some look like a skin tag or a small mushroom (pedunculated polyps). These are the two most common shapes of colon polyps, but there are others. Some are harmless, but others may be a cancer risk.
Like growths on the skin, colon polyps form naturally and are very common, especially in older adults. Some are harmless, but some might become cancerous. For this reason, people at risk of developing colon polyps or colorectal cancer should be regularly screened to catch and remove them early.
Polyps result from cells in the large intestine lining that grow faster than they should. Some of these growths involve cells that line the colon and rarely become cancerous. All they do is grow too much; these polyps are called hyperplastic polyps (the word hyperplastic means “overgrown”). Others form from the cells that secrete mucus. These are called adenomatous polyps or “gland tumor polyps.” These polyps grow in a disorganized way (dysplasia). Cancer, too, grows in a disorganized way. Adenomas will not necessarily all turn into cancer. The cells inside could transform into cancer cells under the right circumstances. Serrated polyps are another common type of colon polyp that can become cancerous.
Colon polyps are a common health condition mainly affecting older adults.
Colon polyps are caused by a combination of factors, including genetics, diet inflammation, digestive system problems, or just getting older.
Risk factors for colon polyps include advancing age, family history of polyps or colorectal cancer, male sex, inflammatory bowel disease (IBD), high-fat, low-fiber diet, smoking, and obesity.
Colon polyps usually have no symptoms, but if they become large, in some cases, symptoms might include blood in the stools with no pain, rectal bleeding, or mucus in the stool.
Colon polyps usually require a colonoscopy or special imaging test (such as a virtual colonoscopy) for a diagnosis .
Colon polyps are usually removed when identified, since they can potentially turn into cancer. Colon polyps typically resolve when they are removed.
Treatment of colon polyps may include endoscopic removal of the polyp or more invasive surgery to remove part or all of the colon in people with severe polyp diseases.
Colon polyps may be preventable by dietary changes, smoking cessation, and maintaining a healthy weight.
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The causes of colon polyps are imperfectly understood, but a multitude of factors can contribute to the development of colon polyps:
Inherited conditions
Some people are born with hereditary conditions that cause them to develop colon polyps. One of these conditions is called familial adenomatous polyposis, or FAP. People born with this trait can have dozens to thousands of adenomatous polyps in their colon. They are at risk of developing colon cancer in their 30’s or 40’s.
Genetics
Even people without inherited polyp conditions are more likely to develop polyps if they have family members with a history of colon polyps or colorectal cancer.
Aging
The normal aging process seems to contribute to the development of colon polyps.
Injury
Damage to the colon lining may contribute to forming benign hyperplastic polyps.
Inflammation
People with inflammatory bowel disease, particularly ulcerative colitis, often develop a type of benign colon polyp called inflammatory polyps or pseudopolyps.
Diet
What people eat may affect polyp formation. People who eat a lot of red meat or lack fiber have been shown to be at a higher risk of developing polyps.
People are more likely to develop colon polyps if they have certain risk factors, including:
Advancing age
Male sex
Inherited polyp conditions
Family history of polyps or colorectal cancer
High-fat, low-fiber diet
Smoking
Excessive alcohol use
High BMI
Colon polyps are not always a serious or health-threatening problem. Though some colon polyps (adenomas) may evolve into cancer, most hyperplastic polyps are harmless. Those that do develop into cancer take years or up to a decade before becoming cancerous. Colon polyps are very common, particularly in older people. They typically have no symptoms, but some large polyps may bleed or cause other problems.
See a healthcare professional for blood in bowel movements or rectal bleeding. It may be due to certain types of polyps, but there may be a more serious reason for the bleeding other than polyps. If there are symptoms of colon cancer such as red blood in the stools, rectal bleeding, abdominal pain, weight loss, or new-onset constipation that last for a week or more, see a healthcare provider Otherwise, if you’re older than 45, ask a primary care physician about colorectal cancer screening. Because colon polyps have no symptoms and can evolve into colon cancer, screening tests are the most effective way to prevent colorectal cancer.
RELATED: Colon cancer symptoms: what are the early signs of colon cancer?
Colon polyps are primarily diagnosed through a colonoscopy, though some people may first be screened with a CT scan or X-rays. In a colonoscopic procedure, a gastroenterologist, a specialist in the gastrointestinal system, will insert a flexible tube attached to a camera (called a colonoscope) into the rectum and examine the lining of the colon carefully. The gastroenterologist will identify any polyps by sight. Most of the polyps detected will be removed during the colonoscopy.
RELATED: Does medicare cover colonoscopy?
Genetics do play a role in the development of colon polyps. People with a family history of colon polyps or colorectal cancer are more likely to get colon polyps.
Polyps can also be caused by some heritable disorders. People with these conditions typically develop many colon polyps, a condition healthcare professionals call polyposis. One of these conditions is familial adenomatous polyposis (FAP). People with FAP can develop dozens to thousands of adenomatous polyps, which may develop into colorectal cancer. On average, people with FAP get diagnosed with colon cancer in their 30s or early 40s.
Additionally, several rare types of hereditary polyposis conditions primarily affect children and teens. The colon polyps they develop are called hamartomatous polyps. These polyps can develop into cancer, so people with these conditions have an increased risk of getting colon cancer. Depending on the condition, there may be other symptoms such as polyps throughout the digestive system or dark spots on the skin, lips, or the inside of the mouth.
RELATED: Why is family health history so important?
Colon polyps are not an immediate health threat, but some polyps may develop into cancer. Because of the cancer risk, doctors usually remove all precancerous polyps that are found during a colonoscopy. The procedure is called a polypectomy. Very-low-risk polyps may be left alone until the next colonoscopy. If polyps are removed, another follow-up colonoscopy will be scheduled to check for new or missed polyps. The timing will depend on the doctor’s assessment of the risk, but it can be anywhere from one to seven years after polyp removal.
In certain circumstances, a part of the colon may be removed. People with familial adenomatous polyposis may have all of their colon and rectum removed to prevent colorectal cancer.
RELATED: Colon Cancer Treatments and Medications
Healthcare professionals aren’t certain if polyps can be prevented. Based on what we know about risk factors, a few steps might help:
Maintain a healthy body weight
Avoid red meats and fats
Increase the amount of fiber in the diet
Increase calcium and vitamin D intake
Polyps may be harmless, but some may progress to colon cancer. Since they have no symptoms, the best way to diagnose colorectal polyps is to have a colonoscopy. If that’s too scary, there are less invasive screening tests such as a CT scan or barium enema X-ray. If you are 45 or older and don’t have a family history of polyps or colon cancer, ask your primary doctor about getting screened for colon cancer. If you do have a family history of polyps or colon cancer, ask the primary doctor for advice about the best age to start screening for colon cancer.
RELATED: The cancer screenings men need | The 5 cancer screenings women need
Healthcare professionals don’t know if particular foods cause colon polyps. They do know that diet is a risk factor, so they suspect diet might play a role in the development of colorectal polyps. Foods that are believed to increase the risk for colon polyps include red meats and saturated fats. Foods that reduce the risk of colon polyps are fiber and calcium-rich foods.
Stress is not known to be a cause or risk factor for polyps.
Once removed, colon polyps can sometimes return to the same place but usually show up elsewhere in the colon. The speed with which new polyps show up after a polypectomy depends on the type and number of polyps removed. Typically, people who have had polyps removed will be asked to schedule a follow-up colonoscopy. The timing will vary but could be within one to three years after polyp removal if many polyps were removed.
Colonic polyps: diagnosis and surveillance, Clinics in Colon and Rectal Surgery
Colorectal polyps, StatPearls
Colorectal polyps and polyposis syndromes, Gastroenterology Report
Colorectal screening and surveillance, American Family Physician
Colorectal polyps, StatPearls
Understanding polyps and their treatment, American Society for Gastrointestinal Endoscopy
Role of life events in the presence of colon polyps among African Americans, BMC Gastroenterology
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