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By the way, doctor: Polyps that come back

By the way, doctor

Polyps that come back

Q. Should I worry if new colon polyps appear near where previous ones have been removed?

A. The simple answer is, “It depends.”

The large intestine is a large tube, and a polyp is a growth out from the inside wall of that tube into the hollow center. Polyps are common: More than half of people over age 60 have them. Some polyps never cause any symptoms. Others cause symptoms, such as bleeding, but never turn cancerous. But adenomatous (pronounced ad-eh-NO-ma-tus) polyps can turn into cancer if not identified and removed. Adenomatous comes from adenoma, the medical term for any tumor that grows from the epithelium, a layer of glandular cells that line the inside of an organ.

Polyp Most polyps in the colon have a stalked, mushroom-like shape. Many are benign, and some go away on their own. It may take five years for a polyp to become cancerous.

Some rare genetic conditions, such as familial adenomatous polyposis and Gardner’s syndrome, cause polyps that nearly always turn into cancer. Even in the absence of these rare conditions, if one of your parents or siblings has had an adenomatous polyp, your risk of having one is elevated fourfold. And if you’ve had an adenomatous polyp diagnosed and removed, you’re at greater risk of developing more of them. They can occur near the old polyp or anywhere in the colon.

I don’t think you should worry, but you should be monitored closely. If your first polyp was an adenomatous polyp and a new one has developed close to where the old one was, the new one also should be removed — and your entire colon should be carefully examined for other polyps. In fact, you should have a colonoscopy every 5–10 years.

Anthony L. Komaroff, M.D., Editor in Chief, Harvard Health Letter

Last updated:	August 21, 2006