If polyps were found and removed during your colonoscopy, you may be concerned about what this means for your risk of colorectal cancer. Most colorectal cancers start as polyps, which are small growths that form on the inner lining of the colon or rectum. Polyps can be found and removed during routine colonoscopies to check for colon cancer. That’s why it’s so important to get screened regularly.
Some people will never develop colon or rectal polyps. Others may have one or a few polyps, and some people may have many. “Polyps are actually more common than people think. Studies show that about 15-40% of all adults have polyps,” said Suneel Kamath, MD, a American Society of Clinical Oncology (ASCO) expert and gastrointestinal oncologist at the Cleveland Clinic.
There are different types of colon and rectal polyps. Most polyps are benign (non-cancerous). But a few types are considered pre-cancerous and are of more concern because they have a higher risk of turning into cancer. If you have had polyps removed, there is a chance that more polyps may develop. You may be wondering what this means for you and your cancer risk. Here’s what you need to know.
What you need to know if you have had colon polyps removed during a colonoscopy
If polyps were found during your colonoscopy, they were most likely removed. If a polyp was very large, a biopsy or sample may be taken instead of removed. Sometimes another procedure is needed to completely remove larger polyps. After polyp or biopsy samples are tested, the results are sent to your doctor.
You may be concerned about how many polyps were found during your colonoscopy. It’s really the type of polyp that makes a difference in what might happen next, rather than the number found. “It’s better to have 5 benign polyps, like hyperplastic polyps, than to have 2 higher-risk polyps, like tubular adenomas that have dysplasia in them,” said Dr. Kamath. “It’s always a combination of the size, number and type of polyps that determines how worrisome things can be.”
If you have had colon polyps removed that have a higher risk of becoming cancer or were found to be suspicious in other ways, you may need additional surgery. “Sometimes, if there is concern that the removed polyp had cancer deeper into the colon wall below the one that was not removed, surgery or endoscopic resection may be recommended,” said Dr. Kamath.
What happens if a polyp that is removed contains cancer
Sometimes polyps found in colonoscopies have already started to turn into cancer. In some cases, the doctor suspects that there may be cancer behind or around where the polyp is located. “If a polyp that is removed contains cancer, your doctor will usually recommend that you have additional imaging tests to make sure the cancer has not spread outside of the colon,” said Dr. Kamath. After that, they will typically refer you to a colorectal cancer surgeon for follow-up surgery and further treatment if needed.
Regardless, if polyps were removed during your colonoscopy, be sure to ask your doctor for details about the polyps. “The most important thing is to understand what types of polyps were removed, how many and how big they were,” said Dr. Kamath. “Based on that, your doctor will be able to tell you what the risk of getting more polyps or cancer would be in the future. That will determine when you need to go back for a colonoscopy again.”
Follow up after polyps were found during a colonoscopy
The follow-up treatment you need if polyps were removed during your colonoscopy depends on your family history, personal risk factors, and the type of polyps found. Your doctor can help you understand your risk and next steps.
- If the polyps were benign: Your doctor may recommend that you continue your usual recommended screening plan. Sometimes, if a large number of benign polyps were found, your doctor may recommend a more frequent schedule for getting routine colonoscopies.
- If the polyps were pre-cancerous: Your doctor may recommend having a repeat colonoscopy within 1 to 3 years. Sometimes it may be best to repeat the procedure within 6 months. This is because your doctor will check the area where each polyp was removed and look for other polyps or problems.
Be sure to write down all follow-up appointments and understand when your doctor says your next procedure should be scheduled. “Write when your next colonoscopy is due on your calendar or phone,” said Dr. Kamath. “I see a lot of people who at the time are worried and prioritize it, but then they relax and forget to plan for it.”
Ways to reduce your risk of colon cancer after polyps are found
If you had polyps removed during your colonoscopy, this may put you at higher risk of developing colorectal cancer. This is especially true if you have found multiple polyps, if the polyps were large, or if they are the type of polyps that have a higher risk of becoming cancer.
In addition to getting routine tests, there are several steps you can take to help reduce your risk of colon cancer. These include:
- Maintaining a healthy weight
- Getting regular physical activity
- Avoid red meat and processed foods
- Avoid alcohol
- Stop smoking
Reasons to talk to your family about your colonoscopy results
It is also important to talk to your family. Polyps found during your colonoscopy may mean that your family members are at higher risk of developing polyps and colon cancer. During family conversations, you may find out that others have also had polyps. Or they may tell you about symptoms they have.
Talking to your relatives is a good opportunity to bring up the importance of:
- Knowing their cancer risk
- Understand screening recommendations for them
- Getting a routine checkup
- To find out the best way forward with their doctor
“We’re probably missing a lot of people who have a family history that increases cancer risk because they don’t know,” said Dr. Kamath.
Finally, since everyone is different, always talk to your doctor about what they recommend to help reduce your cancer risk. They can guide you based on your specific situation.
Dr. Kamath is a member of ASCO’s Patient Information Editorial Board.
