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Forum Name: Colon and Rectal Cancers

Question: Precancerous Polyp


 ShirleyNSB - Sun Dec 03, 2006 6:09 pm

I am 54 years old, female, diagnosed with precancerous polyp 2 years ago during routine colonoscopy (it was removed). Family history includes a paternal uncle who died years ago of colon cancer (before they had today's screenings and improved treatments.)

Can you please (1) define the term "precancerous" and compare it to "cancerous"; (2) provide statistics on patients diagnosed with precancerous polyps; (3) what percent of those diagnosed develop cancer; (4) offer health choices that might help prevent further development into cancerous polyps.

I was told that I shouldn't be alarmed...that this is very common and I just needed to be screened again in 3 years rather than 5. But then when I went to apply for a different health insurance, they want to exclude any conditions related to colon and ileum indefinitely, and will consider a review in a year if I have no procedures whatsoever related to the colon. (A colonoscopy which is due next year is considered a procedure, therefore they would continue to exclude it!) Now that the insurance company has seen fit to be alarmed about it, I feel alarmed even though my doctor stated I shouldn't be. Won't the ability of insurance companies to exclude conditions in this manner make people less likely to follow up with their needed screenings? I trusted my doctor's evaluation and remained calm...now I feel alarmed!
 Dr. Safaa Mahmoud - Thu Dec 21, 2006 3:11 pm

User avatar Hello,

It would be helpful if you can send us the results of the pathological study for the removed polyps. It would be also helpful if you can inform us about any other tests done for diagnosis of your case like genetic studies.

Aadenomatous polyps are premalignant (precancerous).
It is a condition in which cells show changes which do not signify malignancy (cancer) but are potentially moving towards cancer or malignant behavior.

Consideration for those with intestinal polyp is recognized in the young, 2 or more polyps, when colonic carcinoma before 40 years, and with associated extraintestinal manifestations.

A variety of polyposis syndromes can affect the GI tract and are divided as:
- Familial inherited (autosomal dominant) or
- Non familial.

The inherited polyposis syndromes are further divided into
-Adenomatous: (like the classic familial adenomatous polyposis (FAP)). Patients usually present with polyps at age of 35. Colonic cancers usually develop in all patients with FAP within 20 years after the diagnosis.

Current recommendations for follow up include colonoscopy, and small-bowel follow-through every 2 years after diagnosis.

- Hamartomatous: (like juvenile polyposis syndrome). Family history may not be present,(is more likely to be your diagnosis).
The average age of presentation is 20 years.

Recommendations for patient with Juvenile Polyposis include an upper and lower endoscopy every year, If no polyps are seen the examinations can be done less often (every two to three years) since the risk for cancer in small although significant.

Keep us updated.
 ShirleyNSB - Fri Dec 22, 2006 12:24 pm

Thank you for taking the time to respond to this. I know your schedule is busy and I appreciate it more than you know.

So if I am almost sure to develop cancer later on, what do I do now other than keep up with my screenings? Does changing ones diet really significantly change the outcome? Do I continue to take my low dose hormones (PremPro .45/1.5 mg)? Or could that increase my chances to develop cancer?

I will contact my doctor and request a copy of the lab report.

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