A colonoscopy is more than a diagnostic tool—it’s a life-saving preventive measure. During a routine colonoscopy screening, doctors examine the lining of your colon for abnormalities such as polyps. These small growths may seem insignificant, but they can serve as early warning signs for colorectal cancer.
Discovering polyps doesn’t always mean bad news, but it does signal the need for further action and understanding. If your colonoscopy screening shows polyps, your doctor will take several steps to evaluate the type, size, and risk associated with them. This article explains what polyps are, why they matter, and what happens next so you can feel more prepared and informed about your health.
What Are Polyps and Why Do They Form?
Polyps are abnormal tissue growths that form on the inner lining of the colon or rectum. They vary in size, shape, and risk level. Some are flat and difficult to detect, while others are raised and easier to spot. Many polyps are harmless (benign), but some carry the potential to turn into cancer over time. The exact cause of polyps is not always known, but factors such as age, genetics, diet, smoking, and chronic inflammation in the gut can all contribute. The risk of developing polyps increases with age, especially after 50.
Types of Polyps Detected During a Colonoscopy
There are two main categories of colon polyps:
- Adenomatous (Adenomas): These are the types of polyps most likely to develop into cancer. They can vary in risk depending on their size and whether they show high-grade dysplasia (abnormal cells).
- Hyperplastic and Inflammatory Polyps: These are usually benign and rarely progress to cancer. However, their presence may still warrant future monitoring depending on their number and location.
Knowing which type of polyp has been detected helps your doctor determine your risk level and recommend the right follow-up care.
Immediate Steps: What Happens During the Colonoscopy?
If polyps are found during a colon cancer screening, most of them are removed immediately in a process called a polypectomy. Using a wire loop or biopsy forceps inserted through the colonoscope, your doctor carefully removes the growths. This is generally a painless procedure due to sedation. In some cases—especially if the polyps are very large or have certain characteristics—they may not be removed immediately. Your doctor might instead take a biopsy or schedule a follow-up procedure to remove them safely with more specialized tools.
Pathology Analysis: Why Polyps Are Sent to the Lab
Once polyps are removed, they’re sent to a pathology lab for examination under a microscope. This analysis determines the type of polyp and whether there are any cancerous or precancerous cells. You’ll typically receive your lab results within a week. The findings from pathology help your doctor classify the risk level and recommend the appropriate surveillance schedule. A benign polyp with no signs of dysplasia may not require urgent follow-up, while a high-risk adenoma will likely necessitate a closer watch.
Risk Factors and Surveillance Recommendations
Your future screening schedule depends heavily on the number, size, and type of polyps found:
- 1–2 small adenomas (<10 mm): A repeat colonoscopy may be recommended in 5 to 10 years.
- 3 or more adenomas, or any larger than 10 mm: You may need a follow-up colonoscopy in 3 years.
- Advanced features (e.g., high-grade dysplasia): A more frequent surveillance interval may be necessary—possibly within a year or two.
Your personal and family history of colorectal cancer also influences how often colorectal cancer screenings are advised.
Is It Serious If You Have Polyps?
Finding polyps can be concerning, but it’s not always an indication of cancer. In fact, removing polyps early significantly reduces your risk of developing colorectal cancer. The key is timely detection and follow-up. While most polyps do not become cancerous, some have the potential to do so if left untreated. That’s why colonoscopy screening is such a powerful tool—it allows for both detection and prevention in a single session.
Lifestyle Adjustments After Polyp Detection
If polyps are discovered, your doctor may suggest lifestyle changes to reduce the risk of recurrence. These can include:
- Increasing dietary fiber by eating more fruits, vegetables, and whole grains
- Reducing red and processed meat intake
- Avoiding tobacco products and limiting alcohol
- Exercising regularly and maintaining a healthy weight
- Considering calcium and vitamin D supplements if advised
These habits not only lower your risk of future polyps but also support overall colon health.
What Happens If a Polyp Is Cancerous?
In rare cases, a polyp may already contain cancerous cells. If detected early, the cancer might be fully removed during the polypectomy. However, if the cancer has penetrated deeper layers of the colon wall or shows signs of spreading, further treatment may be required.
This could include additional imaging tests, a surgical consultation, or even chemotherapy depending on the stage of cancer. The good news is that when caught during a colonoscopy screening, colon cancer is highly treatable and often curable in its early stages.
The Importance of Follow-Up and Staying on Schedule
Your doctor will create a personalized follow-up plan based on your results. It’s critical to follow this schedule to detect any new polyps early before they have a chance to grow or change. Ignoring or delaying recommended surveillance colonoscopies could mean missing the opportunity to remove polyps before they become dangerous. Staying proactive gives you control over your health and peace of mind.
Talking to Your Doctor About Next Steps
After receiving your pathology report, your doctor will explain what type of polyp was found, how risky it is, and what actions to take. Don’t hesitate to ask questions such as:
- What type of polyp did I have?
- Was it removed completely?
- When should I schedule my next colonoscopy?
- Are there lifestyle changes I should make?
- Do I need any additional imaging or treatment?
Understanding your results helps you make informed decisions about your care.
Conclusion
Finding out you have polyps during your colonoscopy screening can be unsettling, but it’s also a powerful opportunity. Most polyps are harmless and easily removed before they cause harm. Even if your polyp has signs of early cancer, early detection gives you the best chance of a full recovery.
What happens next depends on the type of polyp, how many were found, and your individual risk factors. By following your doctor’s advice, making smart lifestyle choices, and keeping up with follow-up screenings, you can take charge of your colon health with confidence.
