If you have polyps, how far are you from cancer?

Expert of this article: Hu Zhongdong, chief physician of the Health Management Center of Changsha Third Hospital, deputy chief physician, member of the Youth Science Popularization Innovation Professional Committee of Hunan Medical Education and Technology Association

"Polyps" often appear in many people's physical examination reports. When some people see this result, they begin to worry whether the polyps will turn into cancer and want to remove them quickly. But will all polyps turn into cancer? In fact, this matter requires specific analysis of specific issues. Let's take a look together.

polyp

Polyps are abnormal growths of tissue protruding from the surface of the mucosa. Before their pathological nature is determined, they are collectively referred to as polyps. Polyps may occur wherever there is mucosa in the human body.

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Please don’t panic if you encounter “polyps” because not all polyps will turn into cancer.

What determines the risk of polyps becoming cancerous?

Studies have shown that in addition to genetic factors, the appearance of polyps is also related to chronic stimulation of inflammation. Irregular diet, smoking, alcoholism, staying up late for a long time, liking to eat spicy and high-fat foods, sitting for a long time and other bad living habits, as well as the stimulation of basic gastrointestinal lesions, are all related to the occurrence of polyps and even cancer.

In addition, whether a polyp will become cancerous is related to factors such as the size, type, shape, number, and location of the polyp. Generally, the larger the polyp, the higher the chance of canceration. Adenomatous polyps have a high canceration rate, while hyperplastic polyps have a very low canceration rate. Polyps with pedicles and smooth surfaces have a low canceration rate; while polyps without pedicles (wide base), uneven surfaces, depressions in the middle, and cauliflower-shaped polyps have a high canceration rate.

These polyps will almost always turn into cancer.

Colorectal polyps

Inflammatory: The inflammation will disappear on its own after it is cured.

Adenomatous: generally does not disappear on its own and has a tendency to become malignant

Colorectal cancer (CRC) is the third most common malignant tumor in the world. It usually evolves through the "adenoma-carcinoma" development pattern. Early detection and timely treatment of colorectal polyps, especially adenomatous polyps, can significantly reduce the incidence of colorectal cancer.

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Familial adenomatous polyposis (FAP) is a group of autosomal dominant syndromes characterized by multiple colorectal adenomas. Clinical manifestations include abdominal pain, diarrhea, bloody and mucus in the stool. If not treated actively, almost all patients will develop colorectal cancer. For those with a family history of digestive tract cancer, be sure to be vigilant about FAP. Regular colonoscopy can effectively prevent the occurrence of colorectal cancer.

Once colonoscopy finds polyps or small tumors in the intestine, they can be removed immediately and a biopsy can be taken to determine whether they are malignant tumors.

Do family members of FAP patients need genetic testing?

Currently, there are three more clear types of hereditary colorectal cancer: Lynch syndrome, familial adenomatous polyposis (FAP), and Peutz-Jeghers syndrome (PJ syndrome).

Among them, FAP is caused by abnormal mutations in the APC gene. Gene mutations can be detected in more than 90% of typical FAP patients, and all their first-degree relatives are likely to be ill (50% probability). Therefore, clinically diagnosed FAP patients and all their immediate family members should undergo genetic counseling and genetic testing.

How to deal with polyps in different parts of the body?

Whether polyps in the body need to be removed depends on specific analysis of the specific problem.

Nasal polyps

Symptoms of nasal polyps include nasal congestion, excessive mucus, olfactory dysfunction and headaches. Nasal polyps usually do not turn into cancer. If the symptoms are obvious and medical treatment is ineffective or there are multiple large polyps, endoscopic nasal polypectomy can be used.

Vocal cord polyps

Long-term improper voice, long-term adverse stimulation or chronic inflammation are all related to the appearance of vocal cord polyps. Vocal cord polyps can easily lead to hoarseness and even obvious difficulty in speaking. Once you have symptoms of hoarseness, foreign body sensation in the throat, dry and itchy throat, it is recommended to go to the hospital immediately for a fiberoptic laryngoscopy to make a clear diagnosis. If necessary, you can also undergo surgery under the doctor's advice to remove it.

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Gallbladder polyps

Generally speaking, gallbladder polyps are mostly benign lesions. However, we should be highly vigilant for single gallbladder polyps, because they have a certain possibility of canceration. Especially for those with a diameter greater than or equal to 1 cm, single, wide pedicle, or local gallbladder wall thickening, rapid growth in a short period of time, or accompanied by gallstones and obvious clinical symptoms, those suspected of malignant transformation or malignant lesions should undergo cholecystectomy as soon as possible.

Gastric polyps

Some gastric polyps have the risk of becoming cancerous and may develop into gastric cancer. The most effective way to detect gastric polyps is gastroscopy. Polyps suspected of or already cancerous, as well as polyps with a diameter greater than 2 cm, must be removed to reduce the occurrence of gastric cancer, and the polyps should be sent for pathological examination.

Cervical polyps

Most cervical polyps are benign lesions, but they may also become cancerous. If you are over 45 years old, especially women with cervical polyps before and after menopause, the polyps should be removed in time and sent for pathological examination.

Endometrial polyps

Endometrial polyps may cause prolonged menstruation, increased menstrual flow, irregular vaginal bleeding, and even infertility. Whether or not to undergo surgical treatment is closely related to the presence or absence of symptoms and whether or not the woman has reached menopause. If there is gynecological inflammation, seek timely treatment. For symptomatic endometrial polyps ≥1 cm, timely surgical removal and medication are recommended to avoid recurrence.

Since the risk of polyps becoming malignant is highest after menopause, it is recommended that postmenopausal women have polyps removed in a timely manner to prevent cancer.

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