Polyp (medicine): types, detection, treatment and clinical importance

Characteristics and terminology

Polyps are described by their shape and microscopic features. A growth attached by a narrow stalk is called pedunculated, while one with a broad base is termed sessile. Histologic categories include inflammatory, hyperplastic, adenomatous (glandular), hamartomatous and serrated polyps. Adenomatous and certain serrated lesions are of greatest concern because they can be precancerous, especially in the colon.

Common locations and symptoms

• Colon and rectum: may cause bleeding, change in bowel habits, or be asymptomatic and found on screening.
• Nasal and sinus polyps: can cause nasal obstruction, reduced sense of smell and recurrent sinusitis.
• Uterine (endometrial) polyps: may cause abnormal uterine bleeding.
• Other sites: stomach, bladder, vocal cords and ear canals.

Diagnosis

Identification depends on location: colonoscopy or sigmoidoscopy for colorectal polyps, endoscopy for gastric lesions, nasal endoscopy for sinonasal polyps and ultrasound or hysteroscopy for uterine polyps. Diagnosis usually requires visual inspection and biopsy to determine histology and malignancy risk.

Treatment and follow-up

Small symptomatic or suspicious polyps are often removed at the time of endoscopy (polypectomy). Larger or invasive lesions may need surgical excision. Management decisions consider polyp type, size and number; some patients require regular surveillance with repeat endoscopy to monitor for recurrence or new lesions.

Prevention and notable points

Screening programs, particularly for colorectal polyps, reduce cancer risk by detecting and removing precancerous lesions. Lifestyle measures such as a healthy diet, regular exercise and avoiding tobacco may lower risk. Not all polyps become malignant, but appropriate evaluation and follow-up are important to identify those that do.