Types of Colon Polyps - Understanding Your Colonoscopy Pathology Report

October 18, 2021

4 min read

Colon cancer, also known as colorectal cancer is classified as cancer involving the colon or rectum, which are located at the lower end of the digestive tract. In 2021, there were more than 100,000 new cases of colon cancer and more than 45,000 new cases of rectal cancer, according to the American Cancer Society.

Colorectal cancer is easily detectable through a medical procedure called a colonoscopy performed by a licensed professional. Your pathology report is chock-full of medical jargon that might be difficult for you to understand. Below is a basic guide to understanding some of the terms in your colonoscopy pathology report.

What is a colonoscopy?

A colonoscopy is known as an examination of the distal part of the small bowel and the large bowel and with a CCD or fiber-optic camera that is attached to a flexible tube that is then passed through the anus. This medical procedure is performed by a licensed physician and requires sedation.

During a colonoscopy, your physician will assess visually for any abnormalities including polyps. If a small polyp is discovered it will be removed during the colonoscopy, however, larger polyps require surgery for removal. A sample of the tissue will then be sent to a pathologist for further examination.

What is on a pathology report?

A pathologist is a licensed professional who specializes in examining tissue from the body and diagnosing diseases. The sample is removed through a biopsy or surgery and sent to a pathologist for evaluation. The pathologist will then prepare a report that will be sent to your doctor who will provide you with the results. The pathology report will include the following:

Patient demographics
A description of the procedure including how and where the sample was taken
A description of how the specimen looks to the naked eye, including weight, color, and size
A microscopic description
Tumor cell type
Histologic grade: how the cells of the sample differ from normal cells
Lymphovascular invasion: if any cancer cells are present in the lymph or blood system
T-stage: tumor size and how far it has moved into the colon
Lymph nodes: how many were tested versus how many are cancerous
Margins: determine how far cancer cells go near or beyond the edges of the colon
Diagnosis

Common types of polyps

A colorectal polyp is classified as an abnormal growth involving the lining of the colon or rectum. These polyps are classified into three categories: hyperplastic, sessile serrated, or adenomatous.

Hyperplastic polyps: Hyperplastic polyps are usually benign growths, meaning they are not precancerous or cancerous. These types of polyps often do not require removal.
Sessile serrated adenomas: These are the most common types of adenomas accounting for 15 to 20 percent of serrated polyps. Sessile serrated adenomas are precancerous polyps that require removal.
Adenomatous: Adenomatous polyps are precancerous polyps, meaning they are at risk of turning into cancer.

Risk factors

Colorectal polyps are a common ailment affecting between 15 to 40% of adult Americans. While polyps can affect anyone, there are a few risk factors associated with this condition including:

Age: 50+ years old
Family history of polyps or cancer
Red meat diet
History of inflammatory bowel disease
Tobacco and/or alcohol use
Obesity

When will I get my colonoscopy test results?

During a colonoscopy, your physician will examine the large bowel and distal part of the small bowel using a camera attached to a flexible tube. If there are no abnormal findings, meaning there are no polyps or concerning areas that require further evaluation, you will likely receive your test results after you wake up from sedation.

Due to the possible confusion from the sedatives given before the procedure, your doctor will often provide you with written and verbal test results or may have you come into the office on a separate day.

If any abnormal tissues are found during the procedure, your physician will remove a tissue sample that will then be sent to a pathologist for further examination. This route can take up to a week or more for the results to come back.

Once you have received the testing results, it’s recommended to request a copy for your records. Your doctor will make a recommendation on further testing and/or treatment that may be needed depending on your pathology report. It’s also important to understand your results, so if you’re confused, be sure to reach out to your doctor.

Foundations, Coalitions, and Societies

Colon Cancer Coalition

Colon Cancer Foundation

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