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Bowel Cancer: Risky Polyps May Be More Common Than Expected

Doctor Direct Endoscopy

A gastroenterologist from NSW believes ‘risky’ polyps in the colon that is related to what causes bowel cancer or bowel problems could be more common than experts think. They’re called ‘sessile serrated’ polyps and the presence of them in the bowel is known as the  ‘serrated polyposis syndrome’. The polyps can point to an increased risk of bowel cancer and were once considered rather rare. It was thought about one in 3,000 people had the risky bowel polyps, but recent research suggests it could be much more common.

Gastroenterologist, Dr Stuart Kostalas, from Port Macquarie on the NSW Mid-North Coast, carried out a study on the suspect bowel polyps and has submitted his findings to a medical conference in Europe later this year. Polyps aren’t necessarily bowel cancer causes, because most of them are benign(1), which means they are harmless. However, polyps are caused by an abnormal growth of cells which – like cancer cells – grow by rapidly dividing, so they can turn malignant and very harmful if not detected early and removed.

What You Need to Know About Bowel Cancer:

  • After lung cancer, bowel cancer is the second most deadly cancer in Australians
  • The figures are one in 13 will develop cancer during their lifetimes
  • The risk of bowel cancer rises sharply and progressively after age 50
  • A free stool test done at home is available through the National Bowel Cancer Screening Program and people are strongly encouraged to take advantage of it
  • The good news is, 90 percent of cases of bowel cancer can be treated successfully if found early, so people are encouraged to do the free test, and if necessary have a colonoscopy, according to Bowel Cancer Australia

Bowel cancer causes are unknown(3), however, age and diet are contributing factors and those at higher risk have polyps and a family history of bowel cancer. Other high-risk factors are problems such as inflammatory bowel diseases like Crohn’s disease or ulcerative colitis.

Direct Endoscopy is one of the largest providers of endoscopy services in Victoria with 20 years of experience in bowel problems –

We also have four Day Hospitals in the Melbourne metropolitan area

The Bowel Polyp Study

Dr  Kostalas studied the results of almost 4,000 colonoscopies done at his Port Macquarie practice between January 2015 and March 2018 and found serrated polyposis syndrome in the bowels of almost three per cent of the patients. Dr Kostalas told ABC News(2) the results were due to several factors, including improved detection methods, technology, better training and better bowel preparation.

The serrated polyps and others have been on the radar recently with regard to medical issues, according to Dr Graham Newstead, a colorectal surgeon and director of Bowel Cancer Australia. For instance, Dr Newstead says a few years ago, London’s St Marks Hospital pathologist Jeremy Jass discovered the polyps were different to others. He says the serrated polyps are hard to see; they grow similar to a flat polyp and don’t look much different to the lining of the bowel, so they’re hard to find. These polyps are a higher risk than the others for developing into bowel cancer, which means patients with these polyps need more regular colonoscopies.

At Direct Endoscopy, we’re happy to see anyone with bowel problems at any time, and at short notice –

We can access the public hospital system and have admitting rights to major public hospitals

Changes to Bowel Cancer Screening May be Needed

In order for sessile serrated polyps to be detected earlier, Dr Kostalas believes Australia’s bowel cancer testing guidelines might need to be refreshed, Dr Newstead also thinks the guidelines should be revised, with family histories taken into account when deciding whether a person needs a colonoscopy or stool testing. Doctors treating patients who are found to have sessile serrated polyps need revised guidelines to decide how often testing will be needed after a positive result. The problem is that there are risks with colonoscopies themselves, so it’s a matter of getting it right by not having too many colonoscopies, but enough so the polyps can be found and removed.

More research is also needed on sessile serrated polyps, according to Dr Newstead, who says there’s no literature on the sub-groups of patients with sessile serrated adenoma. This means doctors can’t recommend when a patient should have a colonoscopy. Colorectal surgeons are left to consider them case-by-case, with reliable background information.

At Direct Endoscopy, You will enjoy a warm and friendly atmosphere, with our highly qualified gastrointestinal specialists and staff offering the very best in patient care

Low Participation in Bowel Cancer Screening

Unfortunately, Dr Newstead says, less than 40 percent of the free, very simple Government screening tests sent out to people in the post are returned because people look at them and say ‘yuk’, and throw them in the bin saying, ‘I’m not doing that!’, or words to that effect. And a recent Cancer Institute NSW study revealed, alarmingly, that the main reason given by people who failed to use the free bowel screening kit was that they were ‘too busy’.

For Dr Newstead, the fact that humans spend their lives discussing what they eat but never talk about what comes out the other end because it’s not so pleasant is a bit odd. People have babies so they ‘know what yucky poo is’, so they should be used to it, he says – and people should be encouraged to talk freely about their colonoscopies and bowel problems. Dr Newstead hopes that if more people tell others they’ve had a stool test or colonoscopy, that it wasn’t terrible, that the surgeon found a polyp and it saved them from bowel cancer, surely people will realise the great benefit.

If you have bowel problems and need a colonoscopy, call Direct Endoscopy today on 9781 5959and make an appointment at any of our 4 convenient locations.


Dr David Badov
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