What to Know If Polyps Were Found During Your Colonoscopy

If polyps were found and removed during your colonoscopy, you might be worried about what that means for your colorectal cancer risk. Most colorectal cancers start as polyps, which are small growths that form on the inner lining of the colon or rectum. Polyps can be found and removed during routine colonoscopies to check for colorectal cancer. This is why getting screened regularly is so important.

Some people will never develop colon or rectal polyps. Others may have one or a few polyps, and some people may have many. “Polyps are actually more common than people think. Studies show about 15-40% of all adults have polyps,” said Suneel Kamath, MD, an American Society of Clinical Oncology (ASCO) expert and gastrointestinal oncologist at the Cleveland Clinic. 

There are different types of colon and rectal polyps. Most polyps are benign (non-cancerous). But a few types are considered pre-cancerous and are more concerning because they have a higher risk of turning into cancer. If you’ve had polyps removed, there is a chance that more polyps can develop. You might be wondering what that means for you and your cancer risk. Here’s what to know.

What to know if you’ve had colon polyps removed during a colonoscopy

If polyps were found during your colonoscopy, they were most likely removed. If a polyp was very large, a biopsy or sample may have been taken instead of removing it. Sometimes another procedure is needed to remove larger polyps completely. After polyp or biopsy samples are tested, results are sent to your doctor.

You might be worried about how many polyps were found during your colonoscopy. It’s really the type of polyp that makes a difference in what might happen next, rather than the number found. “It's better to have 5 benign polyps, like hyperplastic polyps, than to have 2 higher-risk polyps, like tubular adenomas that have dysplasia in them,” said Dr. Kamath. “It's always a combination of the size, number, and type of polyps that determines how concerning things might be.”

If you’ve had colon polyps removed that have a higher risk of becoming cancer or that were found to be suspicious in other ways, you might need additional surgery. “Sometimes, if there is concern that the polyp removed had cancer deeper into the wall of the colon below it that was not removed, surgery or endoscopic resection may be recommended,” said Dr. Kamath.

What happens if a polyp that is removed contains cancer

Sometime polyps found in colonoscopies have already started to become cancer. In some cases, the doctor suspects there might be cancer behind or around where the polyp is located. “If a polyp that is removed contains cancer, your doctor will usually recommend you get additional imaging tests done to make sure that the cancer has not spread outside of the colon,” said Dr. Kamath. Then, they will typically refer you to a colorectal cancer surgeon for follow-up surgery and further treatment if needed.

No matter what, if polyps were removed during your colonoscopy, be sure to ask your doctor for details about the polyps. “The most important thing is to understand what types of polyps were removed, how many, and how big they were,” said Dr. Kamath. “Based on that, your doctor will be able to tell you what the risk of getting more polyps or cancer would be in the future. That will determine when you need to come back for a colonoscopy again.”

Follow-up after polyps were found during a colonoscopy

The follow-up care you’ll need if polyps were removed during your colonoscopy depends on your family history, personal risk factors, and the type of polyps found. Your doctor can help you understand your risk and next steps.

• If the polyps were benign: Your doctor might recommend continuing  your usual recommended screening schedule. Sometimes, if a large number of benign polyps were found, your doctor might recommend a more frequent schedule for getting routine colonoscopies.
• If the polyps were pre-cancerous: Your doctor may recommend getting a repeat colonoscopy within 1 to 3 years. Sometimes, repeating the procedure within 6 months might be best. This is because your doctor will want to check the area where each polyp was removed and look for other polyps or problems.

Be sure to write down all follow-up appointments and understand when your doctor says your next procedure should be scheduled. “Put when your next colonoscopy is due in your calendar or phone,” said Dr. Kamath. “I see a lot of people who, at the time, are worried and make it a priority, but then they relax and forget to schedule it.”

Ways to reduce your risk of colon cancer after polyps were found

If you had polyps removed during your colonoscopy, this can put you at higher risk for developing colorectal cancer. This is especially true if you had multiple polyps found, if the polyps were large, or if they are the types of polyps that have a higher risk of becoming cancer.

Along with getting routine testing, there are several steps you can take to help reduce your colorectal cancer risk. These include:

• Maintaining a heathy weight
• Getting regular physical activity
• Avoiding red meat and processed foods
• Avoiding alcohol
• Quitting smoking

Reasons to talk to your family about your colonoscopy results

It’s also important to talk to your family. Polyps found during your colonoscopy may mean your family members are at higher risk for developing polyps and colorectal cancer. During family talks, you might find out that others have had polyps, too. Or they might tell you about symptoms they’re having.

Talking with your relatives is a great opportunity to bring up the importance of:

• Knowing their cancer risk
• Understanding screening recommendations for them
• Getting routine checkups
• Figuring out the best path forward with their doctor

“We probably miss a lot of people who do have a family history that increases cancer risk because they don't know it,” said Dr. Kamath.

Finally, since everyone is different, always talk with your doctor about what they recommend to help reduce your cancer risk. They can guide you based on your specific situation.

Dr. Kamath is a member of ASCO’s Patient Information Editorial Board.