polyps, adenoma, colon cancer

Polyps are growths of the mucous membrane that occur everywhere in the gastrointestinal tract, but more often in the large intestine and rectum. Except for the harmless hyperplastic polyps of the mucous membrane, it is otherwise adenomas. In the course of the so-called adenoma-carcinoma sequence, every adenoma turns into a malignant tumor after around 10 years. 85% of all colorectal carcinomas develop from adenomas. Adenomas are therefore a precancerous stage or an intermediate stage between a benign growth and a malignant disease.

It is therefore plausible and extremely important to carry out a comprehensive preventive examination so that as many adenomas as possible can be removed endoscopically and a colorectal carcinoma is avoided. According to international recommendations, a screening colonoscopy should be performed in women over the age of 50 and in men over the age of 45 if the family history is normal and the patient is free of symptoms. In the case of a higher risk constellation (removal of an adenoma, colon cancer in the family), the recommendation is from the age of 40 or 10 years before the diagnosis of the first colon cancer in the family. If there is a genetic disposition (FAP and HNPCC), the first colonoscopy is recommended as early as childhood or young adulthood.

If stool irregularities, peranal blood loss, unclear abdominal problems, etc. occur, a colonoscopy is recommended immediately, regardless of age.

Regular colonoscopies save lives!

Compared to virtual colography with computed tomography or magnetic resonance tomography, colonoscopy has clear advantages in terms of resolution and the possibility of taking a tissue sample or therapy by removing the polyp (s). The resolution has improved in the last few years through HD devices (high definition) and through color filters - narrow band imaging (NBI) or pit pattern—so that small and flat polyps can be diagnosed through this increase in contrast and also through mucosal resection extensive areas can be resected.

The colonoscopy has also gained acceptance, as bowel preparation with modern preparations is no longer so stressful and the examination itself is carried out under sedation. Follow-up care after removal of polyps depends on the histology.