Have you ever had a colonoscopy? Or maybe you've heard of one from your family or friends. Sometimes after this test, the doctor says, "You have a polyp in your colon." It's normal for anyone to feel a little scared or shocked when they hear these words. But should you really be scared? Are all these polyps dangerous and cancerous? No. Today we're talking about a special type of polyp that forms in the colon called serrated polyps .
Simply put, what are serrated polyps?
Serrated polyps are small growths of tissue, or rather, small polyps, that form on the inner wall of your colon. They are called "serrated" because their surface looks like saw-toothed when viewed under a microscope.
The important thing is that these polyps are not cancerous when they first form. They are usually benign. However, some serrated polyps can turn into cancer over time. That's why doctors remove these polyps as soon as they are seen. This helps prevent colon cancer from developing in the future.
The way these serrated polyps develop is a little different from the way other common polyps, called adenomas, develop. And the process by which they turn into cancer is also different. About 25% of colon cancers develop from these serrated polyps. But if they do develop into cancer, they can grow a little faster than other types.
What are the main types of serrated polyps?
The World Health Organization (WHO) has divided serrated polyps into four main types. These are classified based on their appearance and the way the cells behave. Not all of these types turn into cancer. Therefore, it is very important for your doctor to accurately classify and identify them.
Here is a simple explanation of those four types.
| Polyp Type | Simply put... |
|---|---|
| Hyperplastic polyps | This is the most common type. About 75% of serrated polyps are of this type. The good news is that they are harmless and do not turn into cancer . They are a normal condition caused by a small amount of excess cell growth. |
| Sessile serrated lesions (SSLs) | This is the most common type of serrated polyp that is most likely to turn into cancer . "Sessile" means "sessile" because they are flat and attached to the wall. This is why they are sometimes difficult to find during a colonoscopy. Doctors consider all of these SSLs to be at risk of cancer. |
| Traditional serrated adenomas | These are very rare . Although they look like normal adenomas, they also have "serrated" features, like saw teeth. They are also a type of cancer . |
| Unclassified serrated adenomas | This is a type of polyp that doesn't exactly belong to any of the three types mentioned above, but has hybrid characteristics. This is also rare. Doctors are continuing to research these. |
How common are these tumors? Are there any symptoms?
Imagine, if you do 100 colonoscopies, you can see this type of serrated polyp in about 30 of them. But don't worry, the majority of those found are harmless hyperplastic polyps . Types like SSLs, which are at risk of cancer, are found in a small number, about 10%.
The important thing is that none of these types of polyps usually cause any symptoms . You can have them inside your body without even realizing it.
Very rarely, if a tumor grows, you may experience a small amount of blood in your stool, or you may experience bloating or constipation. But there are more likely other causes for these symptoms. That's why doctors recommend getting a colonoscopy at an early age, even if you don't have any symptoms.
What is serrated polyposis syndrome (SPS)?
This is a rather special, rare condition. In this condition, a person develops many serrated polyps (sometimes more than 20) throughout their colon. These can be larger than normal and may be of a higher risk type of cancer. A person with this condition, SPS, has a 25% risk of developing cancer.
What are the causes and risk factors for these?
There is no single cause for colon polyps. They are more common as we age. The main cause is thought to be genetic mutations that occur when our cells divide and make new cells. Just like a copying machine sometimes makes small mistakes. These genetic mutations cause cells to grow out of control and form tumors.
There are several factors that increase the risk of developing these polyps:
- Being over 50 years old
- Smoking
- Excessive drinking
- Regular consumption of red meat (such as beef and pork)
- Weight gain (obesity)
- Having chronic inflammatory conditions of the intestines, such as inflammatory bowel disease (IBD)
How are these detected and treated?
The best and only way to detect serrated polyps is with a colonoscopy . This test examines your entire colon using a thin tube with a camera attached.
But sometimes it can be a bit challenging to find them. Because types like SSLs are flat, the same color as the surrounding tissue, and the borders are not clear. That's why it's important to have a skilled, experienced doctor perform this test using high-tech cameras (high resolution colonoscopes).
What happens after the test?
1. Detection: If the doctor sees a polyp during a colonoscopy and suspects it is a high-risk type, he or she will remove it immediately. This procedure is called a polypectomy .
2. Testing: The removed polyp is sent to a lab, where a pathologist examines it under a microscope to determine exactly what type of polyp it is and provides a report.
3. Future plans: Based on that report, your doctor will decide how soon you need to have your next colonoscopy.
| Type of polyp found | Recommended time for the next colonoscopy |
|---|---|
| Low risk (e.g. small hyperplastic polyps) | Normally in 10 years |
| Medium risk (e.g. multiple SSLs) | In about 5 years |
| High risks (e.g. large SSLs or multiple ones) | In about 3 years |
| If SPS status is available | Every year |
Your doctor may change these times depending on your condition, so it is essential to follow his instructions.
Don't forget, removing a polyp that is at risk of cancer means you are completely safe for now. We have eliminated the possibility of that growth developing into cancer. However, it is important to get checked again at the appropriate time, as these growths can recur.
Take-Home Message
- Serrated polyps are a type of growth that forms in the colon. Most of these are harmless .
- However, some types, such as SSLs, can turn into cancer over time, so it's best to remove them as soon as you see them.
- These tumors do not cause any symptoms . That's why it's important to have a colonoscopy after the age of 45, as recommended by your doctor.
- If a polyp that was found during your exam was found to be cancerous and was removed, don't worry. It means your doctor saw it in time and prevented it from developing into cancer.
- The most important thing is to have your next test exactly at the time the doctor tells you . Don't miss it.
- You can reduce the risk of developing these by avoiding smoking, excessive alcohol consumption, and following a healthy lifestyle.
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