Polyps and Adenomas

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Accumulation of mutations in colonic epithelial cell DNA affecting oncogenes and tumor suppressor genes which leads to tumor initiation (formation of adenoma) tumor progression (adenoma to carcinoma).

Neoplastic polyps: adenomas (tubular, villous, tubulovillous dysplasia), sessile serrated adenomas/polyps (concern for interval CRC), carcinomas.

Non-neoplastic polyps: hyperplastic, juvenile, Peutz-Jeghers, inflammatory.

Investigations

Colonoscopy is gold standard

Note

• Colonoscopy in all patients starting at age 50 years, then typically every 10years unless pathology found.
• If positive family history, start age 40, or 10 years before age of diagnosis in youngest family member, repeat every 5 years.