Colonic Polyps and Cancer
Polyp is a discrete mass of the tissue, that protrude into the lumen of the bowel
Polyps are categorized as non neoplastic polyps and neoplastic polyps
Non neoplastic polyps
- Hyperplastic polyps
- Juvenile polyps
- Peutz Jeghers polyps
- Inflammatory polyps
Adenoma are benign neoplastic polyps, and are of two types, tubular and villous adenomas. Polyps which are larger than 2 cms and with villous morphology are more likely to have transformation to malignancy
Polyps less than 5 mm are called diminutive polyp, these polyps are highly unlikely to have malignant potential
- Inherited susceptibility
- Excessive dietary intake of fat and low fiber
- Most of the polyps are clinically silent
- Pain abdomen
- Rectal bleeding
- Diarrhea and constipation
- Colonic obstruction
Detection of Colonic Polyps
- Most of the polyps are diagnosed during colonoscopy.
- Adenomas without deeper invasion can be taken out endoscopically, resected polyp should be submitted for histopathology to confirm the complete resection
- Polyp with invasion of deeper layers should be taken out surgically
Colon cancer is a major cause of morbidity and mortality
- High fat low fiber diet
- Colorectal adenomas polyposis syndromes
- Family history of colorectal cancer
- Ulcerative colitis and Crohn’s disease
- Tumor on the right side of the colon, are larger in size and present with chronic bleed and there may be palpable mass also
- Tumor on the left side of the colon present with change in bowel habits, pain abdomen, anemia and chronic bleed’
- Colonoscopy is done for confirmation of diagnosis, biopsy is taken from abnormal areas for histopathological confirmation
- CECT abdomen and chest are done to r/o distant metastasis
- Surgery is the treatment of choice for colon cancer
- Patients with advanced disease (disease beyond serosa/lymph node positive cases patients with liver metastasis) should be offered
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