Colorectal polyps

Case history

On routine screening, a 70-year-old man is found to have a positive fecal immunochemical test (FIT). He is asymptomatic but has a family history of cancer of the colon. Abdominal and rectal exams are normal. A colonoscopy subsequently reveals a polyp in the descending colon but no other abnormalities.

Other presentations

Polyps are frequently an incidental finding during colonoscopic exam for another condition or as a response to screening for colorectal cancer involving FIT testing.

Large adenomas may present with bleeding, mucus per rectum, tenesmus, or urgency, although this is very unusual. Polyps can cause intussusception, or remain undetected until they undergo malignant change and cause local and systemic effects.

Polyps may be part of a hereditary condition and be detected during screening in adolescence within an affected family.