Introduction 

Tubular adenomas are a type of colon polyp that can turn into cancer over time. Finding and removing them early helps prevent colorectal cancer.¹ Most are treated during a colonoscopy by removing the polyp. After that, regular check-ups help make sure the polyps don’t come back.

What are tubular adenomas?

Characteristics 

Under the microscope, tubular adenomas are made up of abnormal cells that form tiny tube-shaped glands. Although these polyps can appear anywhere in the colon, the rectosigmoid area is where they are most commonly discovered.¹ Among the main characteristics of tubular adenomas are:

Size: Most are small, less than 1 cm, but larger ones are more likely to turn into cancer.

Dysplasia: This means how abnormal the cells look. The more abnormal, the higher the risk.

Shape: Some are flat, and some sit on a stalk. Flat ones can be harder to remove completely.

Can these polyps turn into cancer?

It can take 10–15 years for some polyps to turn into cancer. This gives doctors time to find and remove them before they cause harm.^2,3

Several risk factors contribute to this transformation:

• Larger than 1cm
• More than one polyp
• Certain shapes (villous or tubulovillous)
• High-grade dysplasia (very abnormal cells)

Given these risks, timely removal and regular surveillance are paramount to preventing cancer.

How are polyps removed during colonoscopy?

Removal methods

1. Cold Forceps Polypectomy:

For very small polyps(less tham <5 mm), doctors use tiny forceps to gently pluck the polyp out. This is quick and safe.⁴

2. Cold Snare Polypectomy: 

For slightly bigger polyps (5–9 mm), a wire loop is used to remove them without heat. This reduces the risk of pain or fever.⁵

3. Hot Snare Polypectomy: 

For larger or more complex polyps, heat is used to help remove the tissue and stop bleeding⁵

4. Endoscopic mucosal resection or endoscopic submucosal dissection:

Sometimes, for bigger or flatter polyps, fluid is injected to lift the polyp before removal. In rare cases, a more advanced technique is used that requires a specially trained doctor.^6,7

What are the risks of removing a polyp?

Polypectomy is safe, but like any procedure, it can have side effects: 

• Bleeding: This is the most common, especially if you’re on blood thinners⁸
• Perforation: A rare but serious tear in the bowel wall
• Post-polypectomy syndrome: A temporary reaction that causes mild pain or fever after the procedure⁸

What happens after a polyp is removed?

Follow-up guidelines

• If your polyps were small and low-risk, you’ll likely need a repeat colonoscopy in 7–10 years⁹
• If you had larger or higher-risk polyps, your doctor may recommend a check-up in 3 year
• If the polyp was removed in pieces or wasn’t completely removed, you’ll likely need a follow-up in 6–12 months

These recommendations stress the value of tailored follow-up plans that strike a balance between cost-effectiveness and early detection.

Factors influencing follow-up recommendations

Several factors can impact surveillance schedules:

• Age: Elderly who have a shorter life expectancy would need less regular monitoring⁹
• Family History: More frequent and earlier colonoscopies may be required if there is a family history of colorectal cancer⁹
• Colonoscopy quality: Insufficient bowel preparation or overlooked lesions may necessitate an early follow-up to guarantee a comprehensive assessment⁹

How can you prevent polyps from coming back?

Lifestyle modifications

Numerous lifestyle changes that have been demonstrated to lessen the risk of colorectal cancer can help patients greatly prevent the recurrence of adenoma:

• Eat more fruits, veggies, and whole grains. Cut back on red and processed meat
• Stay active — regular exercise helps your colon stay healthy
• Quit smoking and limit alcohol
• Talk to your doctor about supplements like calcium or vitamin D¹⁰

Chemoprevention: Can Pills Help Lower Your Risk?

In some cases, certain medications or supplements may help lower your chances of getting new polyps. This is called chemoprevention, using medicine to prevent disease before it starts.

Aspirin and anti-inflammatory drugs

Some research shows that low-dose aspirin and other anti-inflammatory medicines may reduce the risk of polyps coming back. These work by calming inflammation in the colon.

But:

These medicines can cause side effects like stomach pain or bleeding, especially if taken long-term. They're not right for everyone. You and your doctor will need to weigh the benefits and risks before starting them.¹¹

Calcium and vitamin D

Some studies suggest that calcium and vitamin D might also help prevent new polyps. These are safe for most people, but the evidence isn’t yet strong enough to recommend them for everyone.

Tip: Ask your doctor if your current levels are low and whether supplements might help you.¹¹

Conclusion

Tubular adenomas are common, but with early removal and proper follow-up, they rarely become cancer. Regular colonoscopies, healthy habits, and check-ins with your doctor can help you stay ahead of any future problems.

Key takeaways

• Most tubular adenomas are harmless if caught early
• Removing polyps during colonoscopy is safe and effective
• Follow-up schedules depend on the type and number of polyps
• Healthy habits can help prevent new polyps from forming
• Talk to your doctor about what schedule and steps are right for you