Uterine polyps are common growths that develop inside the uterus. This article clarifies their connection to cancer.
What Are Uterine Polyps?
Uterine polyps, also known as endometrial polyps, are overgrowths of the endometrial lining, the tissue that lines the inside of the uterus. They are typically small, soft, finger-like growths, varying in size from a few millimeters to several centimeters. These growths can be attached to the uterine wall by a thin stalk or a broader base. They occur in up to 10% of women.
Common Symptoms
While some individuals with uterine polyps experience no symptoms, others may encounter various signs. The most frequent symptom reported is abnormal vaginal bleeding. This includes bleeding between menstrual periods, unusually heavy menstrual flow, or irregular periods. Post-menopausal bleeding or bleeding after sexual intercourse can also indicate the presence of uterine polyps. Polyps account for about 25% of abnormal bleeding cases in both premenopausal and postmenopausal individuals.
Uterine Polyps and Cancer Risk
The overwhelming majority of uterine polyps are benign, meaning they are non-cancerous. While most polyps are harmless, a small percentage may contain cancerous cells or precancerous changes. Studies indicate that only about 2.73% to 5% of all uterine polyps are found to be cancerous upon examination. A precancerous change often associated with polyps is atypical hyperplasia, which refers to abnormal cell growth in the endometrial lining that is not yet cancer but has the potential to develop into cancer over time if left untreated. It is important to note that a typical, benign uterine polyp rarely transforms into a malignant growth.
Factors Influencing Cancer Risk
Certain characteristics can slightly increase the likelihood of a uterine polyp being malignant or pre-malignant. Post-menopausal status is a significant factor, with the risk of malignancy in polyps increasing to approximately 4.93% to 6% in this group, compared to 1-2% in premenopausal women. Abnormal uterine bleeding, especially in postmenopausal individuals, is also associated with a higher chance of malignancy. Increasing age generally correlates with a higher risk. Additionally, the use of tamoxifen, a medication used in breast cancer treatment, can increase the risk of developing endometrial polyps and, in some cases, may be associated with a slightly higher risk of malignant changes within these polyps, particularly in older individuals.
Diagnosis and Treatment
Diagnosing uterine polyps typically involves imaging techniques and direct visualization. Transvaginal ultrasound is often the initial diagnostic tool, providing images of the uterus. Saline infusion sonography (sonohysterography), which involves injecting saline into the uterus during an ultrasound, offers a clearer view of the uterine cavity and any growths. Hysteroscopy is another effective method, allowing direct visualization of the uterine interior using a thin, lighted scope inserted through the vagina and cervix. This procedure also enables the removal of polyps (polypectomy) at the same time.
Polypectomy is the standard treatment for symptomatic polyps, or for those with a higher risk of malignancy, as it alleviates symptoms and allows for pathological examination of the tissue to confirm diagnosis and rule out cancer. The procedure is generally minimally invasive and often performed in an outpatient setting.