Adenomatous Colorectal Polyps
Adenomatous Colorectal Polyps
Citation: US Gastroenterology & Hepatology Review, 2009;5:58-61
Published: November 2009
Published: November 2009
Abstract
Adenomatous polyps are the most common and clinically significant polyps found within the colon and rectum. When discovered, they are usually asymptomatic and benign in nature. Their significance lies in the fact that adenomas of the colorectum are an intermediate step in the process of carcinogenesis, as almost all colorectal cancers develop from pre-existing benign adenomas. Therefore, the detection and removal of adenomatous polyps is essential in order to reduce the morbidity and mortality associated with colorectal cancer.
Keywords
Adenoma, adenomatous colon polyp, colorectal carcinogenesis, colorectal cancer
Disclosure: Mark Victor Larson, MD, serves as an advisory consultant to GI Nova.
Received: July 14, 2009 Accepted: July 31, 2009
Correspondence: Mark Victor Larson, MD, Gonda 9 East Mayo Clinic, 200 First Street SW, Rochester, MN 55905. E: larson.mark2@mayo.edu
The term colon polyp refers to a protuberance into the lumen from the normally flat colonic mucosa. The different types of colon polyps are referred to as being either non-neoplastic polyps or neoplastic in nature. The non-neoplastic colon polyps include hyperplastic polyps, mucosal polyps (with normal mucosal histology), and inflammatory pseudopolyps. Submucosal lesions may have a polypoid appearance, arising either from a benign lesion, such as a lipoma, hemangioma or fibroma, or from a carcinoid tumor or metastatic lesion.
Juvenile polyps are hamartomatous in nature and are generally considered non -neoplastic, although they can grow to become quite large and result in bleeding, abdominal pain, and even bowel obstruction. Hamartomatous polyps are commonly seen in patients with Peutz- Jeghers syndrome and they not only result in bowel symptoms, they also occasionally undergo malignant transformation. Adenomatous polyps, also called adenomas, are the most common form of colonic polyps, accounting for two-thirds of all colon polyps. They are neoplastic in cature and can develop into an adenocarcinoma of the colon or rectum. They are the most clinically significant colon polyp and will be the focus of the remainder of this article.
Colorectal adenomas are quite common, especially in western countries where the prevalence of colorectal cancer (CRC) is relatively high. While found in only 1–4% of men and women in their 20s and 30s, the incidence of adenomas increases with age, with adenomas found in 25–30% of Americans by 50 years of age and in up to 40–50% of individuals 70 years of age and older.1 Adenomas are more common in men than in women, and more common in black men and women than in white men and women.2 They are distributed throughout the entire colon and rectum; however, they tend to have a more proximal or rightsided colon distribution in women and a slightly more distal distribution in men. Proximal adenomas also appear to be relatively more common in African-Americans.3
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Keywords:
Adenoma, adenomatous colon polyp, colorectal carcinogenesis, colorectal cancer, crohn's disease, virtual colonoscopy, sigmoid colong, gardner's syndrome, juvenile polyposis, colon cancer polyps, colorectal polyps symptoms, polyps symptoms,
Adenoma, adenomatous colon polyp, colorectal carcinogenesis, colorectal cancer, crohn's disease, virtual colonoscopy, sigmoid colong, gardner's syndrome, juvenile polyposis, colon cancer polyps, colorectal polyps symptoms, polyps symptoms,
