Doctors who screen people for intestinal cancer are increasingly concerned about a type of polyp that was once considered harmless: the serrated polyp, or flat lump that grows in the colon, it has a saw-like edge, is almost translucent, and is sometimes not easily visualized during colonoscopy. New studies suggest bowel cancer should be checked more often in people with serrated polyps, writes an expert from Mayo Clinic Healthcare in a commentary by the Gut magazine (Intestine).
Bowel cancer, also known as colorectal cancer, begins in the last part of the digestive tract, in the colon, and usually with small polyps that when benign do not cause symptoms, but gradually become cancerous. Colorectal cancer screening is used to find and remove polyps before they become cancerous. There are different types of polyps and, Until recently, doctors weren’t concerned with serrated polyps.
“The perspective on serrated polyps has come a long way in the last two decades, moving from seeing them as benign lesions that do not turn into cancer to recognizing them as lesions capable of causing up to 33 percent of all colorectal cancer,” notes in the comment Dr. James East, gastroenterologist at Mayo Clinic Healthcare in London.
There are no data to indicate whether colorectal cancer should be more closely monitored in people with serrated polyps, but A large new study, conducted by Dr. Dan Li and his colleagues at Kaiser Permanente and published in Gut, now suggests that those with only serrated polyps or another type of polyp, called an adenoma, may require colonoscopies more frequently, states Dr. East.
Adenomas have long been considered the precursors of cancer, and the Kaiser Permanente study shows that serrated polyps increase the risk for cancer by about the same amount as adenomas, and that the presence of both types of polyps increases even more. that risk, Dr. East notes.
More research is needed to refine the estimate of cancer risk in people who have only serrated polyps or also adenomas to determine the best method of examining each patient, explains the Dr. East.
One possibility would be to set aside risk measurements based on polyp type and instead focus on markers such as the number of polyps, in combination with other risk factors for intestinal cancer, such as obesity, a high-content diet fatty, smoking and high alcohol consumption, or inflammatory bowel diseases, such as Crohn’s disease and ulcerative colitis, adds the doctor.