[이데일리 이순용 기자] Colonic polyps are lesions that protrude from the surface of the colonic mucosa toward the lumen. When these lesions are found in colonoscopy, they are all called colon polyps regardless of histological findings, but subtypes such as adenomas and hyperplastic polyps are classified according to histological findings. Colorectal polyps are very common, and 30-40% of adults over the age of 50 find colon polyps during examination.
Colorectal polyps are largely divided into neoplastic polyps that can develop into cancer and non-neoplastic polyps that do not develop into cancer. A commonly known adenoma is a representative neoplastic polyp that can develop into colorectal cancer. 70% of colorectal cancer begins with an adenoma, and it usually takes 5 to 10 years for an adenoma to become cancerous. Therefore, most cancers can be prevented if adenomas are detected early and removed before they become cancer. In addition, although rarer than adenomas, polyps such as sawtooth squamous lesion (neckless sawtooth lesion) or traditional sawtooth adenoma are also neoplastic polyps that are receiving attention recently.
During colonoscopy, it is difficult to completely distinguish whether a colorectal polyp is neoplastic or non-neoplastic with the naked eye. So, if a polyp is found during endoscopy, it is a principle to remove the polyp, except in some cases where non-neoplastic polyp is certain.
As neoplastic polyps are a pre-stage of colorectal cancer, they have risk factors and causes similar to those of colorectal cancer. There are genetic and biological factors such as family history, gender and age, and environmental factors such as fatty food, red meat, and processed meat intake, fiber deficiency, obesity, smoking, and drinking alcohol.
Professor Park Ye-hyeon of the Department of Gastroenterology at Ewha Womans University Seoul Hospital advised, “Avoiding these risk factors through lifestyle improvement can be a preventative method to prevent colorectal cancer and colorectal polyps.”
Although some polyps cause bleeding, mucus secretions, and changes in bowel habits, most polyps are found incidentally during colonoscopy without symptoms. Therefore, even if there are no special symptoms, if you are over 45 to 50 years old, it is important to receive a colonoscopy regularly to prevent colorectal cancer through the detection and removal of colon polyps.
Colon polyps can be treated by completely removing the polyps through an endoscope. Remove the polyp using tissue biopsy forceps, or perform polypectomy or mucosal resection using an electric snare. In some cases of very large, flat, large polyps, or early colorectal cancer, in addition to these general methods, ‘endoscopic submucosal dissection’, which uses an electric knife that looks like a needle that goes into a colonoscope, is used to remove the underside of the mucous membrane. do. After the polyp is removed, the follow-up examination cycle is different depending on the size, number, and biopsy results of the polyp. Therefore, it is important to follow the recommendations of the gastroenterologist who performed the colonoscopy.
Although it has been recommended to start colonoscopy at the age of 50, recently, the starting age has been extended to 45. In particular, if an immediate family member has a family history of colorectal cancer, it can be started from the age of 40. It is recommended to proceed with colonoscopy until the age of 75, and at the age of 76 to 85, it is decided in consultation with a specialist according to the individual’s choice and individual health condition.
Professor Park Ye-hyeon said, “It is a pity that many people are reluctant to perform colonoscopy because the preparation and endoscopy procedures are cumbersome and difficult. However, if the polyp is removed through a colonoscopy, the risk of colorectal cancer is greatly reduced, so I hope that you do not miss the examination and follow-up examination.”