Polyps and adenomas management

Polyps and adenomas develop due to the accumulation of mutations in colonic epithelial cell DNA affecting oncogenes and tumor suppressor genes. These genetic alterations lead to:

Tumor initiation – formation of an adenoma
Tumor progression – transformation from adenoma to carcinoma

Classification

Neoplastic polyps

These lesions have malignant potential and include:

Adenomas
- Tubular adenoma
- Villous adenoma
- Tubulovillous adenoma
- Adenomas with dysplasia
Sessile serrated adenomas/polyps
- Associated with interval colorectal cancer (CRC)
Carcinomas

Non-neoplastic polyps

These lesions generally have little or no malignant potential and include:

Hyperplastic polyps
Juvenile polyps
Peutz-Jeghers polyps
Inflammatory polyps

Investigations

Colonoscopy

Colonoscopy is the gold standard investigation for the detection, characterization, biopsy, and removal of colonic polyps.

Note Screening colonoscopy is recommended for all individuals beginning at 50 years of age, with repeat colonoscopy typically every 10 years if no significant pathology is identified. For individuals with a positive family history of colorectal cancer, screening should begin at 40 years of age or 10 years before the age at diagnosis of the youngest affected family member, whichever occurs first. In patients with a positive family history, colonoscopy should generally be repeated every 5 years. Histopathological examination of all resected polyps is essential to determine the type of polyp and the risk of malignant transformation.

Imeandikwa:

Jumatatu, 22 Juni 2026, 15:20:12 GMT +3

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