Bowel cancer, also known as colorectal cancer, is one of the most serious health problems affecting adults around the world. In Australia, it is the second leading cause of cancer-related deaths and the fourth most commonly diagnosed cancer.
Every year thousands of people are diagnosed with the disease, and many families are affected by its consequences. Because bowel cancer often develops slowly over many years, doctors believe that early detection and prevention are among the most effective ways to reduce deaths from this illness.
Many cases of bowel cancer begin with small growths inside the large intestine. These growths are called polyps. Polyps form on the inner lining of the bowel and are usually harmless at first. Most people do not notice any symptoms when polyps appear.
In fact, many people may have polyps for years without realizing it. However, some polyps can slowly change over time and develop into cancer if they are not detected and removed early.
Doctors have long known that certain types of polyps are more likely to become cancerous. Two important types are called adenomas and serrated polyps. Adenomas are one of the most common types of bowel polyps and have been widely studied for many years.
Serrated polyps are another type that has received more attention in recent decades as scientists have learned more about their role in bowel cancer development.
A new study led by researchers from Flinders University and Flinders Medical Centre in Australia has revealed an important connection between these two types of polyps.
The researchers found that when both adenomas and serrated polyps appear in the same patient, the risk of developing serious precancerous changes in the bowel increases significantly. The results of the research were published in the medical journal Clinical Gastroenterology and Hepatology.
To explore this question, the research team carefully reviewed more than 8,400 colonoscopy records. A colonoscopy is a medical test in which doctors use a thin flexible camera to examine the inside of the large intestine.
During the procedure, doctors can detect and remove polyps before they develop into cancer. Colonoscopy is widely considered one of the most effective tools for preventing bowel cancer.
The scientists analyzed these records to determine how often different types of polyps appeared together and what risks they might create. Their results showed a striking pattern. People who had both adenomas and serrated polyps at the same time faced a much higher chance of developing advanced precancerous lesions in the bowel. In fact, the risk was up to five times higher compared with people who had only one type of polyp.
The researchers describe the presence of both polyp types as “synchronous lesions.” This means the two types of growths appear together in the bowel during the same time period.
According to the lead researcher, Dr. Molla Wassie from the FHMRI Bowel Health Service, polyps are very common and most do not cause harm. However, when these two specific types occur together, the situation becomes more concerning because the chance of serious bowel disease increases sharply.
Another important discovery from the study was that this combination of polyps may be more common than doctors previously believed.
Nearly half of the patients who had serrated polyps were also found to have adenomas during their colonoscopy examinations. This suggests that the two polyp types may often occur together rather than appearing independently.
The findings support an emerging idea in cancer research that bowel cancer may develop through more than one biological pathway. Adenomas and serrated polyps may represent different routes through which cancer can form.
If both pathways are active in the same patient, the overall risk may increase. This helps explain why some patients develop advanced precancerous changes even when only small polyps are initially found.
The study also suggests that serrated polyps may sometimes develop into cancer more quickly than adenomas. This means that patients who have serrated polyps may need closer monitoring and follow-up examinations. Colonoscopy screening schedules may need to consider the specific types of polyps detected rather than treating all polyps the same way.
Regular screening is therefore extremely important for preventing bowel cancer. Doctors emphasize that polyps become more common as people grow older. Detecting and removing them early greatly reduces the chance that cancer will develop. Colonoscopy allows doctors to remove polyps before they have time to become dangerous.
Health experts often recommend screening beginning at around age 45 for people with average risk. Those with a family history of bowel cancer or bowel disease may need to begin screening earlier.
In Australia, people can also participate in the National Bowel Cancer Screening Program, which offers testing options that can help detect potential problems before symptoms appear.
When reviewing the findings of this study, several important conclusions emerge. First, the research highlights that not all bowel polyps carry the same level of risk.
The presence of multiple types of polyps together appears to significantly increase the likelihood of advanced disease. This suggests that doctors should pay close attention to patients who have both adenomas and serrated polyps.
Second, the study strengthens the understanding that bowel cancer can develop through multiple biological pathways. By recognizing that these pathways may occur at the same time, doctors can design better strategies for monitoring and preventing cancer development.
Finally, the research emphasizes the continued importance of colonoscopy screening programs. Identifying polyps early and removing them remains one of the most powerful tools for preventing bowel cancer deaths.
With improved knowledge about different polyp types, doctors may be able to create more personalized screening plans that better protect patients.
Overall, this study provides valuable new insight into how bowel cancer develops and why some people face higher risks than others. By improving early detection and understanding how different polyps interact, healthcare providers may be able to prevent more cases of this serious disease in the future.
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