Colon Polyps (Colonic Adenoma)

Colon polyps (synonyms: Adenomatosis; Adenomatosis of the colon; Adenomatous polyposis of the colon; Colon polyp; Colon polyps; Familial polyposis; Benign neoplasm of the colon; Benign neoplasm of the colon; Hereditary polyposis coli; Intestinal adenomatous polyposis; Colon adenoma; Colon polyp; Colon polyp; Polyp of the colon; Polyposis coli; Sigma polyp; Sigma polyps; ICD-10-GM K63. 5: Polyp of the colon; ICD-10-GM D12.6: Benign neoplasm of the colon, rectum, anal canal, and anus: colon, unspecified) are neoplasms (neoplasms) in the colon (large intestine) that bulge into the intestinal lumen. About half of these neoplasms are located in the rectum (rectal cavity).

Sex ratio: men are affected slightly more often than women.

Frequency peak: The growth of polyps in the colon begins around the age of 40. The frequency increases sharply with increasing age.

The prevalence (disease incidence) for adenomas in the colon is 20-30% in those over 60 years of age and 75% in those over 70 years of age (in Western Europe and the USA). In other parts of the world, colon polyps are rare.

Polyps may also occur in children (usually aged 2-10 years; peak incidence: 3-4 years) in up to 1% of all children; approximately 90% of these are juvenile polyps with low malignant (malignant) potential. The polyps occur solitary in the rectosigmoid (unit of rectum (rectum) and colon sigmoideum/sigmoid colon; last part of the human large intestine) in 80-90%.

Course and prognosis: Since colon polyps are usually asymptomatic, they tend to be discovered as incidental findings during colonoscopy. Colon polyps, like villous adenoma in particular, can be precancerous lesions (precancerous lesions). About 90% of colon carcinomas develop from colonic adenomas. The rate of carcinoma in adenomas depends primarily on the size of the adenomas. If an adenoma has been removed and there is no evidence of carcinoma, the first follow-up examination should be done after 3 years. If the adenoma was not removed in healthy tissue, a check-up should be scheduled as early as 3 months. If the polyps are not neoplastic, a colonoscopic control after 5 years is sufficient (see “Follow-up intervals” under “Surgical therapy“). Possible complications include ileus (intestinal obstruction), as the polyps can obstruct the passage of stool, and anemia (anemia), which can develop due to blood loss from bleeding polyps. Polyps in the colon are often recurrent (recurring). The recurrence rate is 30-50%. It depends on adenoma-associated factors (villous architecture, degree of dysplasia, location, size, and number of adenomas) and on three other factors: Age, BMI (body mass index; body mass index), and fasting glucose (fasting blood sugar).