Ask An Expert: Bowel Polyps

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Ask An Expert: Bowel Polyps

Question:

If a polyp is found in the bowel, should the bladder also be checked for polyps?

Answer:

No, it is not necessary to search for bladder polyps after a colon polyp is found. Assuming the bowel polyp was removed and was described by the pathologist as an adenomatous polyp, additional colonoscopies should be scheduled to identify and remove any additional polyps that might form, as adenomatous polyps can become malignant over time. However, in nearly all cases there is no need to search elsewhere for growths. The only exception to this is when there is a strong family history of bowel cancer, particularly cancers that arise at an early age (before 50) and occur in first-degree relatives.

A very unusual example of this is a syndrome known as familial adenomatous polyposis. People who are affected develop hundreds, even thousands of polyps, which essentially carpet their colon by the age of 30. Colon cancer inevitably arises within 15 years of the appearance of the polyps. Such individuals need to have their colons removed once the diagnosis is made, and they should be periodically checked for polyps that can transform to cancers in the stomach and duodenum, but not the bladder.

Somewhat more common, accounting for as many as 5 percent of all colon cancers, is a disorder known as hereditary nonpolyposis colorectal cancer (HNPCC). This would be more of a possibility, although still an unlikely one, in a 58-year-old woman with a newly discovered colon polyp. If there is a strong family history of colon cancer, especially occurring early in life or in a first-degree relative, or a family or personal history of cancers developing in other relevant organs, your physician might recommend genetic testing for HNPCC. The other organs that are vulnerable to cancer in people with NHPCC are most notably the uterus and ovary, as well as the stomach, small bowel, liver, bile ducts and ureter. Once again, the bladder is not at risk.

Stephen Goldfinger, M.D., is a professor of medicine at Harvard Medical School. He is a graduate of Columbia College of Physicians and Surgeons, and his clinical base is at the Massachusetts General Hospital.

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Last updated:	January 24, 2007

Medical content reviewed by the Faculty of the Harvard Medical School. Harvard Health Publications, Copyright © 2007 by President and Fellows of Harvard College. All rights reserved. Used with permission of StayWell.

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