|Donald David (Photo by Kaminsky Productions)|
National guidelines recommend that screening for colon cancer begin at age 50 for most people. The process can include a fecal occult blood test, which looks for signs of blood in stool, and physicians also use colonoscopy or sigmoidoscopy to check the bowel for early signs of cancer, including polyps.
Polyps are small knobs of tissue on the bowel wall. They don’t always become cancer, but they present a very serious threat. Donald David, M.D., chief of the Division of Gastroenterology at City of Hope, gives more information about polyps and what they mean.
EHope: How common are polyps?
Donald David, M.D.: Polyps are very common. Almost 50 percent of people at age 50 will have at least one small polyp. Larger polyps are less common, however. That’s fortunate, since larger polyps are more likely to become cancerous.
EH: Can I do anything to avoid getting them?
DD: We think that a high-fiber diet that is low in red meat and especially low in processed meat may reduce the risk of polyps and colon cancer.
EH: What makes polyps become cancerous?
DD: It’s not clear what makes polyps become cancerous, but it appears that certain genes involved with preventing tumors — we call them tumor suppressor genes — may be knocked out. This seems to clear the way for polyps to turn malignant.
EH: Should all polyps be removed?
DD: Yes. We always remove them because we can’t tell if they’re cancerous just by looking at them. We have to send them to the lab.
EH: Is removing them painful, and how long is recovery?
DD: There is no pain associated with polyp removal, and there is no recovery time.
EH: What happens after they’re removed?
DD: All polyps are sent to pathologists who examine them to look for signs of cancer, and the results are given to the patient. The number, size and type of polyps will determine when we schedule the next examination.
EH: Does having a polyp automatically mean you’re at higher risk of cancer for the rest of your life?
DD: It depends on the type of polyp. Hyperplastic polyps generally don’t increase the risk of colon cancer. Adenomatous polyps, on the other hand, are associated with colon cancer. We screen patients having these more frequently depending on the number of polyps and their sizes as well as the patient’s family history of cancer. Generally, having smaller-sized polyps and fewer polyps means lower risk of disease.