Colon polyps natural history, complications and prognosis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sadaf Sharfaei M.D.[2]

Colon polyps are very common in general population. They are usually found during screening colonoscopy. Polyps might grow gradually and cause symptoms including obstruction, bleeding, and changes in bowel habits. Some of them might progress to colorectal cancer. Therefore, it is advisable to resect all polyps that are found during colonoscopy and send the tissue biopsy for pathology. Prognosis of colon polyps is generally excellent. The presence of multiple polyps is associated with genetic disorders with a particularly poor prognosis.

• Colon polyps are very common in general population.^[1]
• They are usually found during screening colonoscopy.^[2]
• Polyps might grow gradually and cause symptoms including obstruction, bleeding, and changes in bowel habits.
• Some of them might have malignant potential.
• If left untreated, it may progress to develop colorectal cancer. The progression from an adenomatous polyp to colorectal cancer may take 10-15 years. 
• All polyps are recommended to be resected.

• Common complications of colon polyps include:^[2][3]
  • Colorectal cancer

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• Gastrointestinal bleeding
• Bleeding following polypectomy

• Prognosis of colon polyps is generally excellent.^[1]
• The presence of multiple polyps is associated with genetic disorders with a particularly poor prognosis.
• Colon polyps that are associated with BRAF and KRAS mutations have a poor prognosis.^[4] This study also found no increase in mortality if 3 or more adenomas (RR = 1.4 [95% CI, 0.6 to 3.0]) or polyps larger than 1 cm

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