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Cancer Genetics

Colon Adenoma Information

07/02/2001

Question:

I`m a 31 y/o female that had an 8mm tubular adenoma removed from my colon. I guess that it`s unusual for someone my age to have these. Are there any implication to having this at my age? Why isn't there any information about younger people getting polyps? Can precancerous cells come from somewhere else in your body?

Answer:

Colon polyps can occur at any age. The most common type is a hyperplastic polyp. Adenomas are another type of polyp. They are less common and are considered to be a precancerous condition. As such, the chance of having an adenoma increases with age, just as the chance of colon cancer increases with age.

There are 3 types of adenomas -- tubular (75%), tubulovillous (15%), and villous (10%). The likelihood of cancer being found differs from type to type -- tubular (5% cancer), tubulovillous (22% cancer), and villous (40% cancer).

Although a person may develop a colon polyp at any age, individuals with a family history of early onset colorectal cancer (under age 50) and/or endometrial cancer may have an increased risk of developing adenomas. This kind of history may mean that the family has Hereditary Non-Polyposis Colorectal Cancer syndrome or HNPCC.

The American Cancer Society guidelines call for colorectal screening at age 50. A person who has had an adenoma at an early age requires more and earlier screening. Once a person has had an adenoma, they should have an annual colonoscopy. If no polyps are found on the subsequent colonoscopy, it can be stretched out to every 3 years unless the person`s family meets the diagnostic criteria for HNPCC. Sigmoidoscopy and stool blood testing are not adequate.

Precancerous colon cells do not come from other parts of the body. They originate right in the lining of the colon.

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Response by:

Judith A Westman, MD Judith A Westman, MD
Associate Professor, Clinical Internal Medicine, Pediatrics and Medical Biochemistry
College of Medicine
The Ohio State University