A hyperplastic polyp of the colon is a common tissue growth discovered during routine colonoscopies. These growths are composed of cells multiplying faster than normal, leading to a small, raised lesion on the lining of the large intestine. While the term “polyp” can be concerning, hyperplastic polyps are the most frequent type of non-cancerous polyp found in the colon. They represent a benign condition in the vast majority of cases.
Identifying Hyperplastic Polyps
Hyperplastic polyps are discovered during a colonoscopy, as they rarely cause any symptoms. Visually, they appear as small, smooth, and slightly raised bumps on the colon wall, usually measuring less than 5 millimeters in diameter. Their color is often similar to the surrounding tissue, which can make them difficult to spot. They are most commonly found in the rectum and the sigmoid colon. To confirm the nature of the growth, a physician performs a biopsy by removing a tissue sample during the colonoscopy for laboratory analysis by a pathologist.
Cancer Risk of Hyperplastic Polyps
For individuals with one or a few small hyperplastic polyps, the risk of them developing into cancer is considered to be exceptionally low. These specific types of polyps are not thought to be precursors to colorectal cancer. Therefore, finding one or two of these during a screening does not usually elevate a person’s overall risk profile for developing colon cancer.
A distinction is made between common hyperplastic polyps and a different category of polyps known as serrated polyps or adenomas. While they can appear similar during a colonoscopy, serrated polyps have a different cellular architecture and carry a recognized risk of progressing to cancer.
A rare condition known as hyperplastic polyposis syndrome (HPS) does carry an increased risk for colorectal cancer. This syndrome is defined by the presence of many hyperplastic polyps throughout the colon, often more than 30, or specific patterns involving larger polyps. In these unique cases, the sheer number and sometimes larger size of the polyps indicate a different underlying biology that requires more intensive monitoring.
Associated Risk Factors
The development of hyperplastic polyps is associated with several factors, primarily advancing age. Individuals over the age of 50 are more likely to have these growths discovered. The natural aging process of cells within the colon lining is thought to contribute to their formation.
Lifestyle factors also play a documented role in the development of these polyps. Smoking is a risk factor, with studies showing a clear link between tobacco use and the presence of hyperplastic polyps. A family history of polyps may also be a contributing element for some individuals.
Removal and Surveillance
Standard medical practice is to remove any polyps found during a colonoscopy, and hyperplastic polyps are no exception. This procedure, known as a polypectomy, is performed using tools passed through the colonoscope. The primary reason for removal is to allow a pathologist to examine the tissue and confirm its type, definitively ruling out a more concerning serrated adenoma.
Once one or two small hyperplastic polyps are removed and confirmed by a pathologist, the follow-up recommendations are straightforward. If no other abnormalities like adenomas are found, the patient is advised to return to the standard screening schedule. For most average-risk individuals, this means a repeat colonoscopy in 10 years.