The relationship between polyps and cancer of the colon and rectum

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Abstract
GENERALLY it is understood that polyps are pedunculated or sessile elevations of the intestinal mucosa. This presentation is based on a review of medical literature on the subjects of adenomas and papillomas, the former representing 90~o of the cases reported. Other classifications of polyps, such as hereditary or familial types, PeutzJeghers, Gardner's diffuse polyposis of the colon, and inflammatory polyps will only be mentioned. There is little controversy concerning what these types represent, or their treatment. Statistics on the incidence of polyps in the general population vary from 1.6 to 17%. s Blatt 4 found polyps in 38.8°0 of colons examined completely as postmortem specimens; and Bargen, s many years ago, reported an incidence of 69~" o in similar specimens by examining them with a magnifying glass. Polyps should be removed End their true nature should be determined accurately by microscopic examination of numerous specimens. In this manner, small areas of carcinomatous invasion can be detected which might have been missed if only single specimens were examined. This might account for instances in which patients have appeared to die of metastatic carcinoma from noninvasive carcinoma found in polyps of the colon and rectum. 3 The presence of cancer can be determined accurately only by histologic examination. Atypism and so-called carcinoma in situ do not justify the diagnosis of carcinoma, which should be made only

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