You may be feeling a bit concerned if you heard the words "colon dysplasia" following a recent colonoscopy, but try not to be alarmed. In simple terms, colon dysplasia refers to abnormal-looking colon cells observed under a microscope. It is typically categorized as either low-grade or high-grade. The good news is that most low-grade colon dysplasias go away on their own. However, high-grade dysplasia presents a different situation. But does having high-grade colon dysplasia automatically mean you have colorectal cancer? Let’s explore this further.
Understanding Colon Dysplasia
Polyps are small clumps of cells that grow on the inside of your colon. Dysplasia refers to how abnormal a polyp appears under a microscope.
Mildly abnormal polyps that don't look much like cancer are considered low-grade (mild or moderate) dysplasia. In contrast, high-grade (severe) dysplasia refers to polyps that are more abnormal and look like cancer.
If your polyp has low-grade dysplasia, there's usually no reason to be concerned. It was probably removed during the colonoscopy, and nothing else needs to be done. However, if a polyp has high-grade dysplasia, your doctor will likely recommend testing on any cells removed during the colonoscopy, and a follow-up colonoscopy sooner than usual to check on that area of the colon.
High-Grade Dysplasia vs. Cancer: What’s the Difference?
High-grade dysplasia is a more advanced abnormal growth pattern compared to low-grade dysplasia, and it is often associated with adenomatous polyps. This condition is characterized by cells that appear highly abnormal under a microscope, such as cells that are larger than normal or arranged in unusual patterns.
High-grade dysplasia does not mean cancer is present. However, it significantly increases the risk of colorectal cancer developing in the future, if left untreated. Because of this, patients with this condition require careful monitoring, including more frequent follow-up colonoscopies.
In most cases, doctors can perform a polypectomy to remove any precancerous polyps identified during the colonoscopy. These polyps are often sent off to the lab for a biopsy, which checks for signs of cancer. Early removal of these polyps helps prevent them from progressing into colorectal cancer.
How High-Grade Dysplasia Develops into Cancer
A colon polyp starts with a gene mutation in one of the many cells lining the colon. These polyps can grow larger as the mutated cells multiply more rapidly and have a longer lifespan. If ignored, a polyp can turn into cancer, eventually invading the mucosa, the innermost lining of the colon, and possibly spreading to other parts of the body.
Generally, the size of the polyp is a key factor in determining how likely it is to become cancerous. The cancer rate jumps significantly when polyps are 10mm or larger. Fortunately, the progression from a precancerous state to cancer is relatively slow, typically taking about a decade.
This is why regular screenings, such as colonoscopies, are crucial starting at age 45. Like many other cancers, symptoms of colorectal cancer usually do not appear until the disease is advanced. Detecting polyps early helps identify potential cancer before it develops.
Related Reading: 5 Common Signs of Colon Cancer That Are Easy to Overlook
It’s important to note that certain factors can increase the risk of forming polyps and the progression to cancer. Risk factors for colon polyps include:
- Genetic changes
- Smoking
- Obesity
- Heavy alcohol consumption
- Poor nutrition, including a high-fat, low-fiber diet
- A history of inflammatory bowel disease (IBD)
While some of these risk factors are out of your control, it's a good idea to make positive changes where you can to help lower your risk.
Treating High-Grade Colon Dysplasia
As already mentioned, your doctor will remove any polyps that show signs of high-grade dysplasia during your colonoscopy and have them evaluated by a pathologist who looks for signs of cancer.
If the dysplasia has progressed to cancer, your doctor will refer you to an oncologist who specializes in treating colorectal cancer. Your oncologist will assess your specific test results and run additional tests to determine the best next steps. Taking multiple factors into consideration, such as the type of cancer and stage, a treatment approach will be recommended.
Some patients may be treated with a surgical procedure known as a colectomy to remove part of the colon. This surgery can be performed either laparoscopically or through open surgery. If your cancer is more advanced, another type of colorectal surgical procedure may be recommended.
Related Reading: Why Surgery is Not Always Part of Colorectal Cancer Treatment
Depending on how far the cancer cells grew into the colon and surrounding areas, additional treatments may be required. These treatments for colorectal cancer can include radiation therapy, chemotherapy, immunotherapy, and targeted therapy.
Preventing Progression: Lifestyle and Risk Management
One of the best ways to take charge of your health and reduce the risk of dysplastic polyps progressing is to get screened regularly. There are several common screening tests available, ranging from at-home tests to brief procedures performed at healthcare facilities. Your doctor can help you choose the most appropriate test based on your age and family history.
The American Cancer Society recommends that individuals at average risk begin screening at age 45. It's important to discuss your personal risk factors with your doctor. If you are categorized as high-risk, your doctor may suggest that you start screening earlier.
Making positive lifestyle changes can also help lower the risk of dysplasia progressing to cancer. Consider eating a healthier diet, exercising regularly, and quitting smoking if you currently smoke.
Colorectal Cancer Treatment in Colorado
Remember, high-grade colon dysplasia doesn’t mean you have cancer. If it does develop into colorectal cancer, keep in mind that it can be very treatable when caught in its earliest stages. Don't skip your screenings and be sure to follow up if something abnormal is found.
If you were diagnosed with colorectal cancer, the cancer specialists at Rocky Mountain Cancer Centers are here to help. Find a location in Denver, Boulder, Colorado Springs, and surrounding areas to schedule an appointment.
