What types of polyps are precancerous and require removal?
Polyps are common benign lesions, usually appearing as masses protruding from the mucosal surface. They can occur in various parts of the body, most commonly in the colon, stomach, gallbladder, nose, and uterine lining. Most polyps are asymptomatic, especially in the early stages, and are often detected incidentally during health check-ups.
In the colon, adenomatous polyps and serrated polyps are the two types with a high potential for malignant transformation. Approximately 75% of colorectal cancer cases arise from adenomatous polyps. Among these, villous adenomas pose the highest risk, followed by tubulovillous and tubular adenomas. Polyps larger than 1cm significantly increase the risk of cancer and are therefore typically recommended for early removal.
Gastric adenomatous polyps also carry a high risk of malignancy, accounting for about 10-20% of gastric polyps. Polyps with a diameter greater than 2cm, villous structure, or dysplasia increase the likelihood of malignancy and should be removed as soon as possible.
For gallbladder polyps, adenomatous polyps are considered high-risk, especially when larger than 1cm. When large polyps or suspected malignancy are present, doctors often advise cholecystectomy (gallbladder removal).
Do polyps cause any symptoms?
The majority of polyps are asymptomatic. However, when they grow large or occur in significant numbers, they may cause:
In the colon: rectal bleeding, constipation, diarrhea, abdominal pain.
In the stomach: abdominal pain, bloating, acid reflux, indigestion, gastrointestinal bleeding.
In the gallbladder: often asymptomatic, but may cause discomfort in the right upper abdomen, especially after fatty meals.
In the nose: nasal congestion, reduced or lost sense of smell, headaches, facial pain.
In the uterine lining: heavy, prolonged periods, abnormal bleeding after menopause.
Can polyps resolve without removal?
Whether polyp removal is necessary depends on various factors such as the type of polyp, size, location, symptoms, and medical history of the patient.
Some polyps may regress spontaneously, such as fundic gland polyps in the stomach, which can resolve after discontinuing proton pump inhibitor medication. However, most polyps will not disappear on their own and may continue to grow, increasing the risk of cancer over time.
Therefore, for polyps with a potential for malignancy, doctors usually recommend removal to prevent dangerous complications.
The decision to remove polyps should be carefully evaluated based on multiple factors. Patients should consult with specialists, follow their advice, and undergo regular monitoring. Adopting a healthy lifestyle and undergoing regular health check-ups are effective measures to prevent the development of polyps.
