The Silent Risk of Sessile Colon Polyps

1. What Are Sessile Colon Polyps?

Sessile colon polyps are abnormal growths that occur on the lining of the colon, characterized by their flat or slightly raised shape. Unlike pedunculated polyps, which grow on a stalk resembling a mushroom, sessile polyps spread directly along the mucosal surface, making them less conspicuous during a colonoscopy. This subtle growth pattern can allow sessile polyps to blend into the surrounding tissue, increasing the risk of being missed during routine screening procedures.

There are several types of colon polyps, including hyperplastic, adenomatous (adenomas), and serrated polyps. Sessile polyps are often associated with the serrated subtype, which has been linked to a higher risk of progressing to colorectal cancer if left untreated. In contrast, pedunculated polyps, with their stalk-like appearance, are usually easier to detect and remove. The flat, broad-based nature of sessile polyps not only complicates detection but can also make removal more challenging for physicians.

For more information on the differences between polyp types, visit the National Cancer Institute and their overview on colorectal polyps.

2. How Sessile Polyps Form

Sessile polyps develop when the cells lining the colon begin to grow and divide abnormally. Under normal conditions, the colon’s mucosal cells follow a tightly regulated cycle of growth, maturation, and shedding. However, genetic mutations or environmental triggers—such as a high-fat diet, chronic inflammation, or family history—can disrupt this process. These disruptions cause certain cells to evade normal growth controls, leading to the gradual accumulation of abnormal tissue that spreads flatly over the colon’s surface.

A relatable analogy is to think of the colon’s lining as a well-manicured lawn. Under healthy conditions, the grass grows evenly and is regularly trimmed. But if weeds take hold and spread across the surface, they can form patches that are hard to notice at first glance. Similarly, sessile polyps spread broadly and blend into the surrounding tissue, making them difficult to distinguish from healthy areas. Over time, unchecked cellular changes can cause these polyps to develop additional mutations, increasing their risk of turning cancerous.

For more information about the cellular mechanisms behind polyp formation, visit this review from the National Institutes of Health.

3. Risk Factors for Development

The likelihood of developing sessile colon polyps is influenced by a combination of genetic, age-related, lifestyle, and environmental factors. Genetics play a significant role—individuals with a family history of colon polyps or colorectal cancer face a greater risk, especially if a first-degree relative has been diagnosed. Certain hereditary conditions, such as Lynch syndrome and familial adenomatous polyposis, are also associated with an increased predisposition to polyp formation.

Age is another important factor; the risk of developing colon polyps rises sharply after age 50, prompting experts to recommend regular screenings for older adults. Lifestyle choices further impact risk. Diets high in red or processed meats, low physical activity, obesity, smoking, and excessive alcohol consumption have all been linked to a higher incidence of colon polyps. Environmental exposures—including chronic inflammation from inflammatory bowel diseases such as Crohn’s or ulcerative colitis—can also contribute.

Understanding these risk factors is crucial to prevention and early intervention. To learn more about risk factors and prevention, visit the CDC’s Colorectal Cancer Risk Factors page.

4. Sessile vs. Pedunculated Polyps

Sessile and pedunculated polyps represent two distinct structural types found in the colon, each with unique clinical implications. Sessile polyps are flat or slightly raised, growing directly along the mucosal lining without a stalk. This broad-based attachment allows them to blend into the colon wall, making them harder to detect and remove during colonoscopy procedures. Their subtle appearance is a significant reason why sessile polyps are sometimes missed in screening, which can increase the risk of progression to colorectal cancer.

In contrast, pedunculated polyps are characterized by a mushroom-like shape, with a rounded head attached to the colon lining by a narrow stalk. This structural difference makes pedunculated polyps more prominent and easier for endoscopists to identify and remove. Clinically, pedunculated polyps are typically less challenging to excise completely, reducing the likelihood of residual tissue and recurrence. However, both types can harbor precancerous or cancerous cells, underscoring the importance of thorough screening.

To see visual comparisons and further clinical details, visit this article from the National Institutes of Health on colon polyp morphology.

5. Why Sessile Polyps Are Hard to Detect

Sessile polyps present a unique diagnostic challenge due to their flat growth pattern and subtle appearance on the colon lining. Unlike more conspicuous polyp types that protrude into the colon’s lumen, sessile polyps grow horizontally, spreading thinly over the mucosal surface. This makes them blend in with healthy tissue, often appearing as slight discolorations or minor textural changes that are easy to overlook, even for experienced endoscopists.

Standard colonoscopy, while highly effective for detecting most polyps, can struggle to reveal sessile varieties—especially if bowel preparation is suboptimal or the polyps are located in hard-to-visualize areas like the right colon. In addition, conditions such as inflammation or the presence of stool residue can further obscure these flat lesions. Advanced imaging techniques, such as high-definition colonoscopy and chromoendoscopy, are increasingly used to enhance detection, but not all screening centers have access to these tools.

For more information on the challenges of identifying sessile polyps and improving screening accuracy, visit the Gastroenterology journal’s review on colorectal polyp detection.

6. The Role of Colonoscopy

Colonoscopy remains the gold standard for detecting and removing colon polyps, including sessile types. During the procedure, a flexible tube equipped with a camera is inserted into the colon, enabling physicians to visually inspect the mucosal surface for abnormal growths. When polyps are identified, they can often be removed immediately using specialized tools passed through the colonoscope, a process known as polypectomy. This capability is crucial for both diagnosing and preventing colorectal cancer, as the removal of precancerous polyps greatly reduces future cancer risk.

However, sessile polyps present specific challenges during colonoscopy. Their flat, broad-based shape allows them to adhere closely to the colon lining, making them less visible than protruding or pedunculated polyps. Incomplete bowel preparation, suboptimal lighting, or the presence of folds in the colon can further hinder detection. Additionally, the removal of larger sessile polyps may require advanced techniques such as endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD), which are not available in all medical facilities.

To learn more about the process and effectiveness of colonoscopy, visit the Mayo Clinic’s page on colonoscopy.

7. Advanced Imaging Techniques

Recent advances in endoscopic technology are significantly improving the detection of challenging lesions like sessile colon polyps. High-definition (HD) colonoscopes provide clearer and more detailed images of the colon’s inner lining, allowing subtle abnormalities to be identified with greater accuracy compared to standard scopes. This enhanced resolution can help clinicians spot flat, faintly colored sessile polyps that might otherwise go unnoticed.

Another promising technique is chromoendoscopy, which involves spraying special dyes onto the colon mucosa during the procedure. The dyes highlight differences in tissue texture and color, making flat or indistinct polyps stand out more clearly against the surrounding healthy tissue. This method has been shown to increase detection rates, particularly for sessile serrated lesions.

Artificial intelligence (AI) is also emerging as a powerful tool in endoscopy. AI-assisted colonoscopy systems use real-time image analysis to detect subtle polyps, alerting endoscopists to areas that require closer inspection. Early studies suggest that AI can help reduce the rate of missed lesions, especially those with flat or irregular shapes. For more on AI in colonoscopy, see this review article in Nature Reviews Gastroenterology & Hepatology.

8. Signs and Symptoms to Notice

Sessile colon polyps are often called “silent” because they rarely cause noticeable symptoms in their early stages. Most individuals with these polyps feel completely healthy, which is why routine screening is so important. When symptoms do occur, they tend to be subtle and may easily be dismissed or mistaken for minor digestive issues. Some people might notice intermittent abdominal discomfort, mild changes in bowel habits, or occasional bloating, but these are nonspecific and can have many other causes.

More concerning signs may develop if a sessile polyp becomes large or starts to bleed. Rectal bleeding, which may appear as blood in the stool or on toilet paper, is one of the few visible symptoms. Other potential warning signs include unexplained iron deficiency anemia (leading to fatigue and weakness) or persistent changes in stool shape or frequency. If you experience these symptoms—especially if you have risk factors for colon polyps—it’s important to speak with your healthcare provider.

To learn more about symptoms and when to seek medical advice, visit the American Cancer Society’s guide to colorectal cancer symptoms.

9. The Link to Colorectal Cancer

Sessile colon polyps, especially those classified as sessile serrated lesions (SSLs), are now recognized as significant precursors to colorectal cancer. Unlike some other polyp types, sessile polyps are more likely to harbor genetic mutations that can disrupt normal cell growth and promote malignant transformation. Over time, these cellular changes can evolve, resulting in dysplasia—a precancerous state—and eventually invasive cancer if the polyp is not detected and removed.

The serrated pathway to colorectal cancer, which involves sessile serrated polyps, is responsible for up to 30% of all sporadic colorectal cancers. These cancers tend to develop more rapidly and may be more aggressive than those arising from traditional adenomatous polyps. Studies, such as those published in The New England Journal of Medicine, emphasize the importance of early detection and complete removal of sessile polyps to prevent progression.

Because of their flat morphology and subtle appearance, sessile polyps pose a greater risk of being missed during screening, underscoring the need for advanced detection methods and vigilant follow-up care.

10. Genetic Syndromes and Polyps

Certain hereditary syndromes dramatically increase the likelihood of developing sessile colon polyps and, consequently, colorectal cancer. Lynch syndrome (hereditary nonpolyposis colorectal cancer, or HNPCC) is one of the most common genetic conditions linked to an elevated risk of sessile serrated polyps and early-onset colorectal cancer. It is caused by inherited mutations in genes responsible for DNA mismatch repair. Individuals with Lynch syndrome not only have a higher risk of colon polyps, but the polyps tend to develop at a younger age and progress to cancer more rapidly than in the general population.

Other syndromes, such as familial adenomatous polyposis (FAP) and mutYH-associated polyposis (MAP), are also associated with increased polyp formation. While FAP is typically characterized by hundreds of adenomatous polyps, it can also lead to sessile polyp development. Genetic counseling and regular surveillance colonoscopies are essential for individuals with these syndromes, as early and frequent screening can detect sessile polyps before they become malignant.

To learn more about hereditary colorectal cancer syndromes and their links to polyp risk, visit the National Cancer Institute’s genetics overview.

11. The Importance of Screening

Routine screening is a cornerstone of colorectal cancer prevention, especially given the silent nature of sessile colon polyps. Most major health organizations, including the U.S. Preventive Services Task Force (USPSTF), recommend that adults at average risk begin regular colorectal cancer screening at age 45. Individuals with a family history or genetic predisposition may need to start even earlier and undergo more frequent testing.

Colonoscopy is regarded as the most effective screening tool, as it allows for both the detection and removal of polyps during a single procedure. Other options include fecal immunochemical testing (FIT), stool DNA tests, and flexible sigmoidoscopy, though these may be less effective in identifying flat, sessile polyps. Regular screening is critical because sessile polyps rarely cause symptoms until they have progressed; early detection enables removal before malignant transformation occurs.

Skipping or delaying recommended screenings increases the risk of undetected polyps developing into cancer. For detailed guidelines and information on screening options, visit the American Cancer Society’s colorectal cancer screening page.

12. Diet and Lifestyle Impacts

Lifestyle choices—especially those related to diet, smoking, and physical activity—play a significant role in the development of colon polyps, including the sessile type. Research shows that diets high in red and processed meats, saturated fats, and low in fiber, fruits, and vegetables are associated with a greater risk of polyp formation. Fiber-rich foods help promote regular bowel movements and may reduce the time potential carcinogens are in contact with the colon lining.

Smoking is another major risk factor; long-term smokers are more likely to develop both adenomatous and serrated polyps, including sessile variants. Smoking is thought to contribute to the buildup of carcinogenic substances in the colon, increasing cellular changes that promote polyp growth. Excessive alcohol consumption has also been linked to greater polyp risk.

On the positive side, regular physical activity has a protective effect. Exercise helps maintain a healthy weight, reduces inflammation, and supports optimal colon function. Even moderate increases in activity levels can lower the risk of polyp development and progression. For practical tips on prevention, visit the CDC’s guide to colorectal cancer prevention.

13. Sessile Serrated Adenomas Explained

Sessile serrated adenomas (SSAs) are a specific type of colon polyp that have garnered increasing attention due to their unique characteristics and heightened cancer risk. Unlike traditional adenomatous polyps, SSAs exhibit a saw-toothed (serrated) pattern of glandular growth when viewed under a microscope. These polyps are typically flat or only slightly elevated, making them difficult to detect during standard colonoscopy procedures. SSAs are most commonly found in the right (proximal) colon and are often larger at the time of discovery compared to other polyp types.

What sets SSAs apart is their association with the serrated pathway to colorectal cancer, a distinct mechanism involving specific genetic and epigenetic alterations. Studies have shown that SSAs can progress to cancer more rapidly and may be responsible for a significant proportion of “interval cancers”—cancers that develop between recommended screening intervals. The subtle appearance and higher likelihood of being missed during colonoscopy make these lesions particularly concerning.

For a detailed overview of sessile serrated adenomas and their clinical significance, consult the American Journal of Gastroenterology’s review article on serrated polyps.

14. Removal Techniques for Sessile Polyps

Removing sessile polyps requires advanced endoscopic techniques due to their flat, broad-based attachment to the colon wall. The most commonly used method is endoscopic mucosal resection (EMR). During EMR, a solution is injected beneath the polyp to lift it away from the deeper layers of the colon, creating a cushion that allows for safer and more complete removal with a snare device. This technique reduces the risk of leaving behind residual polyp tissue and minimizes complications such as bleeding or perforation.

For larger or more complex sessile lesions, endoscopic submucosal dissection (ESD) may be employed. ESD involves carefully dissecting the polyp from the underlying submucosal tissue, enabling en bloc (single piece) removal. While ESD offers a higher chance of complete excision, it is technically demanding and typically performed in specialized centers.

Other adjunctive methods, such as hot snare polypectomy, cold snare resection, and the use of specialized cap-assisted devices, may also be utilized depending on the size and location of the polyp. For more on removal techniques, visit the American Society for Gastrointestinal Endoscopy’s guide to EMR.

15. Complications of Untreated Polyps

Leaving sessile polyps untreated can lead to several serious and potentially life-threatening complications. The most significant risk is the gradual progression from a benign polyp to colorectal cancer. Because sessile polyps, especially sessile serrated adenomas, often harbor genetic mutations, they can transform into cancer more rapidly than other polyp types. Once cancer develops, the chances of successful treatment decrease, and the risk of metastasis to other organs rises.

In addition to cancer risk, untreated sessile polyps can cause chronic bleeding within the colon. This bleeding may go unnoticed initially but can eventually lead to iron deficiency anemia, resulting in fatigue, shortness of breath, and weakness. Larger polyps may also cause bowel obstruction if they grow sufficiently to block the passage of stool, leading to abdominal pain, bloating, and constipation.

Rarely, polyps can ulcerate or become infected, causing further complications such as localized inflammation or infection (colitis). For a deeper understanding of the risks posed by untreated colon polyps, refer to the National Cancer Institute’s overview of polyp complications.

16. Recurrence: Can Polyps Return?

After removal, sessile polyps can sometimes recur, making ongoing surveillance a vital component of post-treatment care. Recurrence rates vary depending on factors such as the polyp’s size, histological type, completeness of the initial removal, and the presence of underlying risk factors. Studies have shown that larger and more complex sessile polyps, particularly sessile serrated adenomas, have a higher likelihood of returning, especially if excision was incomplete or if the patient has a genetic predisposition to polyp formation.

To address these risks, medical guidelines recommend tailored follow-up protocols. Typically, individuals who have had one or more sessile polyps removed are advised to undergo repeat colonoscopy within 3 to 5 years, though the interval may be shorter if high-risk features were present. Regular surveillance enables early detection and removal of any new or recurrent polyps, significantly reducing the risk of progression to cancer.

For more details on recurrence and post-polypectomy surveillance strategies, consult the U.S. Preventive Services Task Force guidelines and the Gastroenterology journal’s recommendations on follow-up care after polyp removal.

17. Impact on Younger Populations

Recent years have seen a concerning rise in the incidence of colon polyps and colorectal cancer among adults under the age of 50. Historically, these conditions were considered rare in younger populations, but emerging data shows that sessile polyps and their malignant progression are increasingly affecting people in their 30s and 40s. According to a study published in Cancer, rates of colorectal cancer in younger adults have increased by more than 2% per year since the mid-1990s.

This shift has prompted leading health organizations to lower the recommended starting age for routine screening from 50 to 45 for average-risk adults. Early detection is especially important for sessile polyps, which are more likely to be missed and may progress more rapidly in younger individuals. Factors contributing to this trend may include changes in diet, sedentary lifestyles, obesity, and possibly genetic predispositions that are not yet fully understood.

Given these changes, it is crucial for both healthcare providers and the public to recognize that colorectal cancer is not just a disease of older adults. For more information, see the CDC’s colorectal cancer statistics.

18. Polyps in Different Parts of the Colon

The location of sessile polyps within the colon significantly influences their detection, risk profile, and clinical management. Right-sided (proximal) sessile polyps—those found in the ascending colon and cecum—are of particular concern. These polyps are more likely to be flat, larger, and exhibit serrated features, making them harder to visualize and remove during colonoscopy. Studies indicate that right-sided sessile polyps are also more frequently missed during screening compared to those located in the left (distal) colon or rectum.

The right colon’s wider diameter and more complex folds can obscure these subtle lesions. Additionally, right-sided sessile serrated adenomas are linked to a more aggressive pathway to colorectal cancer, often progressing more rapidly than their distal counterparts. This makes thorough bowel preparation and advanced imaging techniques especially important for effective screening in this region.

Understanding the impact of polyp location can help inform physician vigilance and patient awareness. For more detailed information about how colonic location affects polyp risk and detection, visit this article from the World Journal of Gastroenterology.

19. Family History and Personal Risk

A family history of colon polyps or colorectal cancer is a significant risk factor for the development of sessile polyps. Individuals with one or more first-degree relatives (parents, siblings, or children) who have been diagnosed with colon polyps or colorectal cancer face a higher lifetime risk compared to those without such a history. This increased risk is partly due to shared genetic factors and, potentially, similar environmental or lifestyle exposures within families.

Research shows that the risk is even greater if the relative was diagnosed at a younger age or if multiple family members have been affected. For example, those with a parent or sibling diagnosed with colorectal cancer before age 60 may need to begin colonoscopy screening earlier—often 10 years before the age at which the youngest affected relative was diagnosed. The presence of certain hereditary cancer syndromes, such as Lynch syndrome or familial adenomatous polyposis, further amplifies both polyp and cancer risk.

Recognizing family history is crucial for developing a personalized screening plan. For guidance on when to start and how often to screen if you have a family history, visit the American Cancer Society’s risk factors page.

20. The Role of Inflammation

Chronic inflammation within the colon is a well-established risk factor for the development of sessile polyps and, ultimately, colorectal cancer. Conditions such as inflammatory bowel disease (IBD)—which includes ulcerative colitis and Crohn’s disease—cause persistent irritation and turnover of the colon’s mucosal lining. This constant state of repair increases the likelihood of genetic mutations and abnormal cell growth, providing fertile ground for the formation of sessile polyps.

People living with IBD often face a higher lifetime risk of developing not only conventional polyps but also serrated and dysplastic lesions. The duration and extent of inflammation are key factors; those with widespread or long-standing disease are at greatest risk. Regular surveillance colonoscopy is recommended for IBD patients, as early detection and removal of polyps can prevent malignant transformation. Furthermore, inflammation can make polyps more difficult to detect, as altered mucosa may mask flat, subtle lesions.

For more information on the relationship between inflammation, IBD, and colon polyp risk, visit this Crohn’s & Colitis Foundation resource.

21. Gender Differences in Risk

Emerging research suggests that gender may influence both the development of sessile polyps and colorectal cancer outcomes. Historically, men have been found to have a higher overall risk of developing colorectal polyps and cancer. Several large studies indicate that men are more likely to develop advanced adenomas and sessile serrated lesions, particularly at younger ages, compared to women. This increased risk has been attributed to differences in hormone levels, genetics, and lifestyle factors such as higher rates of smoking and red meat consumption among men.

However, women are not exempt from risk—especially postmenopausal women. Some studies have shown that after menopause, women may experience a rise in risk, potentially linked to decreased levels of protective hormones like estrogen. Furthermore, sessile serrated polyps are more likely to be located in the right (proximal) colon in women, which can make them more difficult to detect during standard screening. These gender-based differences highlight the need for personalized screening strategies and awareness across populations.

For more on how gender impacts colon polyp risk and screening, explore this review article from the World Journal of Clinical Oncology.

22. The Microbiome Connection

Recent scientific advances have shed light on the crucial role of the gut microbiome—the community of trillions of bacteria and other microorganisms in the digestive tract—in the development and prevention of sessile polyps. Certain bacterial populations are believed to promote inflammation, disrupt normal cell growth, and even produce carcinogenic compounds that may encourage polyp formation. For example, an overabundance of species like Fusobacterium nucleatum has been linked to both polyp growth and colorectal cancer.

Conversely, a diverse and balanced microbiome appears to have protective effects. Beneficial bacteria, such as those that produce short-chain fatty acids (like butyrate), help maintain the integrity of the colon lining, reduce inflammation, and support healthy immune responses. Diets rich in fiber, fruits, and vegetables foster these protective bacteria, potentially lowering the risk of polyp development.

Ongoing research seeks to clarify how manipulating the gut microbiome—through diet, probiotics, or other therapies—might serve as a preventive strategy for colon polyps and cancer. For an in-depth review of current findings on the microbiome’s impact on colorectal neoplasia, visit Nature Reviews Gastroenterology & Hepatology.

23. The Role of Aspirin and NSAIDs

Growing evidence suggests that common medications such as aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) may offer a protective effect against the development of colon polyps, including sessile types. These drugs work by inhibiting enzymes involved in inflammation, such as cyclooxygenase (COX), which have been implicated in the formation and progression of polyps and colorectal cancer. Several large epidemiological studies have shown that regular use of low-dose aspirin or NSAIDs can reduce the incidence of adenomatous and serrated polyps, as well as lower the risk of colorectal cancer in certain populations.

The protective benefit is particularly notable in individuals with a history of polyps or those at higher risk due to genetic factors. However, the use of these medications also carries potential risks, including gastrointestinal bleeding and ulcer formation, making it important for patients to consult with their healthcare provider before starting long-term therapy.

For more information on the chemopreventive effects of aspirin and NSAIDs in colorectal cancer and polyp prevention, see this study in The New England Journal of Medicine and the National Cancer Institute’s overview.

24. Polyps and Iron Deficiency Anemia

Sessile polyps, particularly those located in the right side of the colon, may cause chronic, slow gastrointestinal bleeding that is often not visible to the naked eye. Over time, this subtle blood loss can lead to iron deficiency anemia, a condition in which the body does not have enough healthy red blood cells due to insufficient iron. Anemia caused by occult bleeding is a classic but frequently overlooked symptom of underlying colon polyps or early colorectal cancer.

Symptoms of iron deficiency anemia can be vague and may include persistent fatigue, weakness, shortness of breath, and pale skin. Because these symptoms develop gradually, many individuals do not associate them with a gastrointestinal cause. Medical guidelines recommend that adults—especially those over 50—who present with unexplained iron deficiency anemia undergo a full evaluation, including a colonoscopy, to rule out bleeding from polyps or other lesions.

Early detection and removal of bleeding polyps not only resolve anemia but also prevent potential progression to cancer. For more on the relationship between anemia and gastrointestinal bleeding, see this Mayo Clinic resource on iron deficiency anemia.

25. Sessile Polyps and Screening Challenges in Rural Areas

Access to effective screening for sessile colon polyps is often more limited in rural areas, leading to disparities in early detection and timely treatment. Rural populations may face obstacles such as fewer healthcare facilities, limited availability of gastroenterologists, and longer travel distances to reach specialized care. These barriers can delay routine colonoscopies and reduce the likelihood of advanced imaging techniques being used, increasing the risk that flat, subtle sessile polyps will go undetected.

Socioeconomic factors, lack of health insurance, and limited health literacy further compound these challenges. Many rural residents may not be aware of the importance of early screening or may postpone care due to costs and logistical concerns. To address these issues, healthcare systems are developing solutions such as mobile endoscopy units, telemedicine consultations, and outreach programs to raise awareness and improve access.

Expanding the use of non-invasive screening tools, like fecal immunochemical tests (FIT), can also help identify individuals at risk who may need further evaluation. For insights into rural healthcare disparities and potential solutions, visit the Rural Health Information Hub’s colorectal cancer resource page.

26. Insurance and Financial Barriers

Financial considerations and insurance coverage can significantly impact access to timely screening and treatment for sessile colon polyps. Without adequate insurance, the cost of a colonoscopy or advanced imaging techniques may be prohibitive for many individuals, leading to delays or avoidance of essential preventive care. Even those with insurance may face high deductibles, copayments, or limited coverage for follow-up procedures and polyp removal, particularly if the initial screening test leads to additional interventions.

These financial barriers disproportionately affect low-income populations and those living in under-resourced areas, contributing to disparities in the early detection and management of colorectal polyps. Studies indicate that uninsured adults are less likely to undergo recommended screening and are more likely to be diagnosed at later, less treatable stages. Public health initiatives, such as the CDC’s Colorectal Cancer Control Program, aim to provide free or reduced-cost screening for underserved populations, but gaps remain.

Raising awareness about available financial assistance programs, expanding public insurance options, and advocating for coverage of preventive services are all critical steps in overcoming these barriers. For more information on overcoming financial obstacles, visit the American Cancer Society’s insurance and financial aid page.

27. False Negatives: When Polyps Are Missed

Despite advances in screening technology, sessile colon polyps can sometimes be missed during colonoscopy or other diagnostic tests, resulting in false negatives. The flat and subtle nature of these polyps makes them especially difficult to detect, even for skilled endoscopists. Factors contributing to missed polyps include inadequate bowel preparation, limitations in visualization (particularly in the right colon or behind folds), and the absence of enhanced imaging techniques. Studies have shown that the miss rate for sessile serrated polyps can be as high as 26% during standard colonoscopy.

A false negative result can delay diagnosis and treatment, increasing the risk that a polyp may progress to advanced cancer before it is identified. To minimize this risk, it is vital to ensure optimal bowel preparation, utilize high-definition scopes, and consider adjunct technologies such as chromoendoscopy or artificial intelligence-assisted detection. The expertise and thoroughness of the endoscopist also play a critical role; patients are encouraged to choose providers with strong quality metrics and experience in detecting subtle lesions.

For guidelines on improving screening quality and reducing false negatives, review the American Society for Gastrointestinal Endoscopy’s resources.

28. Polyp Surveillance Intervals

After the detection and removal of sessile colon polyps, appropriate surveillance is essential to prevent recurrence and reduce colorectal cancer risk. The recommended timeline for follow-up colonoscopies depends on several factors, including the number, size, and pathology of the polyps found. For those with one or two small (<10 mm) tubular adenomas or sessile serrated lesions without dysplasia, guidelines suggest a repeat colonoscopy in 5 to 10 years. However, if larger polyps (≥10 mm), multiple polyps, or polyps with advanced features (such as high-grade dysplasia) are discovered, a shorter interval—typically 3 years—is advised.

Patients with more than 10 adenomas or those with a hereditary cancer syndrome may require even more frequent surveillance, sometimes annually. The quality of the initial colonoscopy, including bowel preparation and completeness of polyp removal, also plays a role in determining the interval. Adhering to these recommended timelines is crucial for catching new or recurrent polyps early, before they progress to cancer.

For comprehensive, up-to-date recommendations on surveillance intervals, refer to the U.S. Preventive Services Task Force and the Gastroenterology journal’s guidelines.

29. When to Start Screening

The recommended age to begin screening for colon polyps and colorectal cancer has shifted in recent years in response to rising rates among younger adults. Major health organizations, including the U.S. Preventive Services Task Force (USPSTF) and the American Cancer Society, now recommend that adults at average risk start regular screening at age 45, rather than the previous benchmark of 50. This guideline applies to individuals without symptoms and no family history of colorectal cancer or polyps.

For those with increased risk—such as individuals with a first-degree relative diagnosed with colorectal cancer or polyps, or those with hereditary syndromes like Lynch syndrome—screening should begin even earlier, often at age 40 or 10 years before the youngest affected relative’s diagnosis. The choice of screening test, including colonoscopy, stool-based tests, or flexible sigmoidoscopy, is determined based on personal risk factors and preferences.

Staying informed about updated guidelines and discussing personal risk with a healthcare provider are crucial steps in deciding when to start screening. For more details, refer to the latest American Cancer Society recommendations.

30. The Role of Stool-Based Tests

Stool-based tests have emerged as valuable tools for colorectal cancer and polyp screening, especially for individuals who may not have immediate access to colonoscopy or prefer non-invasive options. Two widely used tests are the fecal immunochemical test (FIT) and stool DNA tests (such as Cologuard). FIT detects hidden blood in the stool, which can be a sign of bleeding polyps or early cancer. Stool DNA tests, on the other hand, analyze stool samples for abnormal DNA shed by cancerous or precancerous cells, as well as for traces of blood.

While these tests are less sensitive than colonoscopy for detecting flat or sessile polyps, they offer the advantage of convenience, no bowel preparation, and the ability to be performed at home. A positive result on either test should be followed by a diagnostic colonoscopy to locate and remove polyps. Regular use of stool-based tests, typically every one to three years, can help identify individuals who would benefit most from further evaluation.

To learn more about the effectiveness, limitations, and recommended intervals for stool-based screening, visit the National Cancer Institute’s colorectal screening fact sheet.

31. Limitations of At-Home Screening

At-home stool-based screening tests, such as the fecal immunochemical test (FIT) and stool DNA assays, have made colorectal cancer screening more accessible and convenient. However, these tests have notable limitations, particularly regarding the detection of sessile polyps. While they are effective at identifying hidden blood or abnormal DNA associated with larger or bleeding lesions, they may miss flat, non-bleeding sessile polyps—especially those in the right colon. Because sessile polyps often do not bleed and shed less abnormal DNA, their presence might not trigger a positive test result.

Additionally, at-home tests cannot provide direct visualization or removal of polyps. A positive result always requires follow-up with a colonoscopy for definitive diagnosis and treatment. False negatives are a concern, as individuals with negative stool-based tests may still harbor sessile or serrated lesions that could progress to cancer if left undetected. For those with higher risk factors, such as family history or previous polyps, colonoscopy remains the preferred screening method.

For an in-depth overview of the strengths and weaknesses of at-home colorectal screening, read the CDC’s guide to colorectal cancer screening tests.

32. Sedation and Patient Comfort During Colonoscopy

Patient comfort is a key consideration during colonoscopy, as apprehension about pain or discomfort can deter many from undergoing this essential screening. Fortunately, a range of sedation options is available to help patients feel relaxed and minimize discomfort during the procedure. The most common approach is conscious sedation, which involves intravenous medications that induce a state of drowsiness and relaxation while allowing the patient to remain responsive. For those who desire deeper sedation, monitored anesthesia care or even general anesthesia may be provided, overseen by an anesthesiologist.

Effective sedation not only reduces pain and anxiety but can also improve the quality of the examination by enabling the endoscopist to perform a more thorough evaluation without patient movement or distress. The choice of sedation is tailored to each individual’s medical history, preferences, and the complexity of the colonoscopy. Ensuring a comfortable experience is crucial for boosting screening rates, as positive experiences encourage future adherence to recommended surveillance intervals.

For more information on sedation options and tips for a comfortable colonoscopy, visit the American Society for Gastrointestinal Endoscopy’s patient resource.

33. Risks Associated with Polyp Removal

While polyp removal during colonoscopy is generally safe and highly effective, it is not without potential risks. The most common complication is bleeding, which can occur either immediately during the procedure or be delayed for several days. Most cases of bleeding are minor and can be managed endoscopically, but occasionally more significant bleeding may require hospitalization or further intervention.

Another potential risk is perforation, where a small tear or hole is created in the wall of the colon. This complication is rare, with reported rates between 0.1% and 0.3%, but it is more likely to occur when removing larger or sessile polyps, or with advanced techniques such as endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD). Perforation typically requires surgical repair and may lead to additional complications if not promptly addressed.

Other, less common risks include infection, reactions to sedation, and localized pain or discomfort after the procedure. Understanding these risks helps patients make informed decisions and recognize symptoms that warrant prompt medical attention. For further details, review the Gastroenterology journal’s article on colonoscopic polypectomy complications.

34. Histology: What Happens After Removal

Once a sessile polyp is removed during colonoscopy, it is sent to a laboratory for histological analysis. In the laboratory, a pathologist examines thin sections of the polyp under a microscope to determine its cellular characteristics. This process identifies the specific type of polyp—such as hyperplastic, adenomatous, or sessile serrated adenoma—and assesses for features like dysplasia (precancerous changes) or invasive cancer.

The results of histology are critical for guiding future care. If the polyp shows advanced features, such as high-grade dysplasia or early cancer, more frequent surveillance or additional treatment may be recommended. Conversely, if the polyp is benign and completely removed, standard follow-up intervals may be sufficient. Histological findings also inform risk assessment for the development of future polyps, helping to tailor screening recommendations to the individual.

Understanding the histological makeup of polyps is essential for both prognosis and prevention. For more detail on how polyps are analyzed and why these findings matter, see the American Cancer Society’s guide to colon and rectal cancer diagnosis.

35. Patient Stories: Early Detection Saves Lives

Real-world patient stories highlight the life-saving impact of early detection and removal of sessile colon polyps. For instance, Mary, a 47-year-old mother of two, underwent her first colonoscopy after her physician recommended early screening due to a family history of colorectal cancer. During the procedure, her doctor discovered a flat sessile serrated polyp in the right colon. The polyp was removed and, upon histological analysis, was found to have precancerous changes. Thanks to prompt screening and intervention, Mary avoided progression to colorectal cancer and now follows a personalized surveillance plan.

Another example is John, a 52-year-old with no symptoms who chose to complete a routine screening colonoscopy. A large sessile polyp was detected and removed using endoscopic mucosal resection. The pathology report confirmed the absence of invasive cancer, and John was able to return to normal activities with peace of mind. These stories underscore the importance of not delaying screening, especially for those with risk factors.

For more inspiring accounts and educational resources, visit the Colorectal Cancer Alliance’s Stories of Hope, which features real patient experiences and the transformative power of early detection.

36. Polyps and Other Digestive Disorders

The presence of colon polyps can sometimes overlap with other common digestive disorders, such as diverticulosis and irritable bowel syndrome (IBS). While these conditions are distinct and have different causes, they may share similar symptoms—such as abdominal discomfort, changes in bowel habits, and bloating—which can complicate diagnosis. Diverticulosis involves the formation of small pouches (diverticula) in the colon wall, whereas IBS is a functional disorder characterized by altered bowel patterns without identifiable structural abnormalities.

Current research does not show a direct causal link between polyps and either diverticulosis or IBS. However, the coexistence of these conditions can influence how symptoms are interpreted and may prompt more thorough evaluations, such as colonoscopy, to rule out polyps or other pathology. It’s important for patients with persistent gastrointestinal symptoms—especially those over 45 or with a family history of colorectal cancer—to discuss comprehensive screening with their healthcare provider.

For more information about the relationship between colon polyps and other digestive disorders, visit the American Gastroenterological Association’s page on diverticulosis and their IBS resource center.

37. Polyps and Medication Interactions

Certain medications can influence the risk of developing colon polyps or complicate their removal during endoscopic procedures. For example, long-term use of immunosuppressive drugs, such as those prescribed after organ transplantation or for autoimmune diseases, has been associated with a higher risk of colorectal neoplasia due to reduced immune surveillance. Similarly, medications that affect hormone levels, such as estrogen replacement therapy, may have a complex impact on polyp risk, with some studies suggesting a modest protective effect and others showing no significant influence.

Commonly used drugs like anticoagulants (blood thinners) and antiplatelet agents (such as warfarin or aspirin) require careful management if polyp removal is planned. These medications can increase the risk of bleeding during or after procedures, so doctors may recommend temporarily adjusting dosages or pausing therapy under medical supervision. Conversely, some studies point to a protective effect of low-dose aspirin or NSAIDs against polyp formation, though this benefit must be weighed against bleeding risk.

For detailed information on how medications may affect colon polyp risk and endoscopic management, visit the American Society for Gastrointestinal Endoscopy’s clinical resources.

38. Innovations in Polyp Detection

Technological advancements are revolutionizing the detection of sessile polyps and other subtle lesions in the colon. One of the most promising developments is real-time artificial intelligence (AI)-assisted endoscopy. AI systems analyze live endoscopic video feeds, flagging suspicious areas that may otherwise be missed by the human eye. Studies have shown that AI can significantly increase the adenoma detection rate (ADR), especially for flat or small sessile polyps that are notoriously difficult to identify.

Other innovations include high-definition (HD) colonoscopes, narrow band imaging (NBI), and chromoendoscopy, all of which enhance visualization of the colon’s mucosal surface. These technologies allow for better contrast and detail, making it easier for endoscopists to distinguish abnormal tissue from healthy mucosa. Capsule endoscopy and computer-aided detection (CADe) systems are also being explored as complementary tools.

With these advances, the future of polyp detection looks increasingly precise and less reliant on operator experience alone. For more on AI and other innovations in gastrointestinal endoscopy, read this review in Nature Reviews Gastroenterology & Hepatology.

39. Psychological Barriers to Screening

Psychological barriers can significantly impact an individual’s willingness to undergo screening for colon polyps, especially sessile types that are often asymptomatic. Common fears include anxiety about discomfort or pain during colonoscopy, embarrassment over the nature of the procedure, and fear of discovering a serious diagnosis. Some people may avoid screening due to misconceptions about the risks involved, or because they associate digestive issues with stigma or shame, particularly in cultures where bowel health is not openly discussed.

Overcoming these barriers requires both education and reassurance. Clear communication from healthcare providers about the safety, sedation options, and life-saving potential of screening can alleviate much of the anxiety. Sharing real patient stories and statistics highlighting the benefits of early detection can further encourage participation. Support from family and friends, as well as resources provided by advocacy organizations, can make a significant difference in motivating individuals to prioritize their colon health.

For practical tips on addressing psychological obstacles and promoting open conversations about colon health, visit the American Cancer Society’s screening information and the Colorectal Cancer Alliance’s resources.

40. The Global Burden of Colorectal Cancer

Colorectal cancer is a major public health concern worldwide, ranking as the third most common cancer and the second leading cause of cancer-related death globally. According to the World Health Organization (WHO), over 1.9 million new cases and nearly 935,000 deaths were reported in 2020 alone. The incidence and risk of colon polyps—precursors to most colorectal cancers—vary significantly between countries, influenced by factors such as diet, lifestyle, genetics, and the availability of screening programs.

High-income nations like the United States, Australia, and many Western European countries have higher rates of both polyps and colorectal cancer, largely attributed to Western dietary habits and sedentary lifestyles. However, these countries also benefit from widespread screening and early intervention, which improves survival rates. In contrast, many low- and middle-income countries are experiencing rising incidence rates as populations adopt more Westernized behaviors, yet screening resources remain limited, leading to later-stage diagnoses and poorer outcomes.

Global efforts to reduce the burden of colorectal cancer include increasing awareness, expanding access to screening, and promoting healthy lifestyle changes. For a comprehensive overview of worldwide trends, visit the International Agency for Research on Cancer.

41. Pediatric Polyps: Rare but Possible

While colon polyps are most commonly associated with adults, they can also occur in children and adolescents, though the incidence is significantly lower. Most pediatric polyps are juvenile polyps, which are typically benign and solitary, but certain hereditary syndromes can increase the risk of developing multiple or atypical polyps at a young age. Symptoms in children may include painless rectal bleeding, abdominal pain, or changes in bowel habits, prompting evaluation with colonoscopy.

Management involves the removal of polyps during colonoscopy, both to alleviate symptoms and to prevent potential complications. In rare cases, polyps in children may harbor precancerous changes, especially in those with a family history of polyposis syndromes such as familial adenomatous polyposis (FAP) or Peutz-Jeghers syndrome. These children require closer monitoring, genetic counseling, and regular surveillance to detect new polyps early.

Awareness of pediatric polyps is important for parents and healthcare providers, as early detection and management can prevent further complications. For more information on pediatric colon polyps, visit the Nationwide Children’s Hospital’s guide to colon polyps in children.

42. Impact of Obesity on Polyp Risk

Obesity is a well-recognized risk factor for the development of colon polyps, including sessile types that are more likely to progress to colorectal cancer. Numerous studies have demonstrated a positive association between increased body mass index (BMI) and both the prevalence and size of colorectal polyps. The underlying mechanisms are believed to involve chronic low-grade inflammation, higher levels of insulin and insulin-like growth factors, and alterations in gut hormones and microbiome composition—all of which can promote abnormal cell growth in the colon.

Individuals with central or abdominal obesity are at particularly high risk, as visceral fat is metabolically active and produces pro-inflammatory cytokines that may contribute to polyp formation. Furthermore, obesity is often associated with other lifestyle factors, such as poor diet and physical inactivity, which independently raise polyp and cancer risk. Weight management through regular exercise, a balanced diet, and lifestyle modification can help reduce the likelihood of both initial polyp development and recurrence after removal.

For in-depth information on the link between obesity and colorectal polyps, see this review article in the World Journal of Gastroenterology.

43. Alcohol and Polyps

Alcohol consumption has been identified as a modifiable risk factor for the development of colon polyps, including sessile polyps that carry a higher risk for malignant transformation. Epidemiological studies consistently demonstrate that individuals who consume higher amounts of alcohol—especially heavy or chronic drinkers—are more likely to develop both adenomatous and serrated polyps compared to non-drinkers or those who drink in moderation. The risk appears to increase with the amount and duration of alcohol intake.

The mechanisms by which alcohol promotes polyp formation are multifaceted. Alcohol and its metabolite, acetaldehyde, can damage the lining of the colon, increase cellular turnover, and promote inflammation, creating an environment conducive to abnormal cell growth. Alcohol may also interfere with the metabolism of folate and other nutrients important for DNA repair and synthesis, further increasing the risk of mutations that lead to polyp development.

Reducing alcohol intake is recommended as part of a comprehensive strategy to lower colorectal polyp and cancer risk. For more detailed information about the connection between alcohol and colon polyps, refer to this National Cancer Institute fact sheet on alcohol and cancer risk.

44. Polyps and Diabetes

Diabetes, particularly type 2 diabetes, is associated with an elevated risk of developing colon polyps, including sessile varieties that are more likely to progress to colorectal cancer. Studies have shown that individuals with diabetes have a higher prevalence of both adenomatous and serrated polyps compared to those without the condition. The link is believed to be mediated by factors such as chronic hyperglycemia, increased levels of insulin and insulin-like growth factors, and systemic inflammation, all of which can promote abnormal cell proliferation in the colon.

Managing sessile polyps in patients with diabetes can be more complicated due to coexisting health issues. Poorly controlled blood sugar may impair healing after polyp removal and increase the risk of infection or delayed recovery. Additionally, diabetes is often associated with obesity and other metabolic conditions, which further heighten polyp risk. Physicians may recommend earlier and more frequent screening for individuals with diabetes, especially if other risk factors are present.

Effective diabetes management, lifestyle changes, and regular colorectal screening are essential strategies for reducing polyp risk and improving overall digestive health. For more information, visit this review article in the World Journal of Gastroenterology.

45. Vitamin D and Calcium: Protective Role?

Growing evidence suggests that adequate intake of vitamin D and calcium may help reduce the risk of developing colon polyps, including sessile types. Several observational studies have found that individuals with higher dietary or supplemental calcium and vitamin D levels have a lower incidence of colorectal adenomas and potentially fewer recurrences after polyp removal. Vitamin D is thought to exert its protective effect by regulating cell growth, promoting cellular differentiation, and reducing inflammation within the colon lining.

Calcium may help by binding to potentially harmful bile acids and fatty acids in the digestive tract, thereby preventing their damaging effects on colon cells. Randomized clinical trials have produced mixed results, but some meta-analyses support a modest benefit of combined calcium and vitamin D supplementation in polyp prevention, particularly in individuals at higher risk. However, supplementation should be approached with caution and under medical supervision, as excessive intake could have adverse effects.

For more information on the role of vitamin D and calcium in colorectal health and polyp prevention, explore this National Cancer Institute overview and the World Journal of Gastroenterology review.

46. Role of Fiber in Prevention

Dietary fiber has long been recognized as a key component in promoting digestive health and reducing the risk of colon polyps, including sessile polyps. Fiber, found in plant-based foods such as fruits, vegetables, whole grains, legumes, and nuts, increases stool bulk and promotes regular bowel movements, which helps decrease the amount of time that potentially carcinogenic substances remain in contact with the colon lining. This mechanical effect may reduce cellular irritation and lower the chances of abnormal cell growth.

Additionally, certain types of fiber are fermented by gut bacteria, producing short-chain fatty acids like butyrate that have anti-inflammatory and anti-carcinogenic properties. Epidemiological studies suggest that diets high in fiber are associated with reduced incidence of colorectal adenomas and cancer. While some randomized trials have yielded mixed results, overall evidence supports the inclusion of adequate fiber as part of a comprehensive strategy for colorectal health.

The American Cancer Society and other health authorities recommend aiming for at least 25-35 grams of fiber daily. For more on the benefits of fiber in polyp prevention, see this World Journal of Gastroenterology review.

47. Smoking and Polyp Risk

Smoking is a well-established risk factor for the development of colon polyps, particularly sessile serrated lesions that have a higher potential for malignant transformation. Multiple studies have demonstrated that both current and former smokers are more likely to develop colorectal polyps compared to non-smokers, and the risk increases with the duration and intensity of tobacco exposure. The carcinogens and toxins in cigarette smoke can damage the DNA of colon cells, promote chronic inflammation, and impair the body’s natural repair mechanisms, all of which contribute to abnormal cell growth and polyp formation.

Research indicates that smoking is especially associated with the formation of sessile serrated adenomas, the type of polyp most likely to be missed during screening and most likely to progress through the serrated pathway to colorectal cancer. Quitting smoking not only reduces the risk of new polyp development but also lowers the chances of recurrence after removal. For those with a history of tobacco use, earlier and more frequent colorectal screening may be advised.

For further reading on the connection between smoking and colon polyps, review this World Journal of Gastroenterology review and the American Cancer Society’s risk factors page.

48. Shared Decision-Making in Screening

Shared decision-making is an essential approach in modern healthcare, particularly when it comes to screening for colon polyps and colorectal cancer. This collaborative process involves open communication between patients and healthcare providers to ensure that screening choices align with an individual’s values, preferences, risk factors, and lifestyle. By thoroughly discussing the benefits, limitations, and potential risks of different screening options—including colonoscopy, stool-based tests, and flexible sigmoidoscopy—patients are empowered to actively participate in their health decisions.

Personalized screening plans are especially important for individuals with unique risk profiles, such as a family history of polyps, genetic syndromes, or underlying medical conditions. Providers can help patients weigh factors like age, risk tolerance, access to care, and the frequency of required follow-up. This approach not only improves adherence to recommended screening intervals but also fosters trust and satisfaction in the healthcare relationship.

For resources and tools to support shared decision-making about colorectal cancer screening, visit the CDC’s screening information page or consult the U.S. Preventive Services Task Force guidelines.

49. Advances in Non-Invasive Detection

Emerging non-invasive technologies are poised to revolutionize the screening and early detection of sessile colon polyps. Among the most promising developments are blood-based and biomarker tests that aim to identify early molecular changes associated with polyp growth or malignancy. These tests analyze circulating DNA, RNA, proteins, or other metabolites in the blood that are shed by precancerous or cancerous lesions in the colon. Early research suggests that blood-based biomarkers, such as methylated SEPT9 DNA, can indicate the presence of advanced polyps or early-stage colorectal cancer with reasonable sensitivity and specificity.

In addition to blood tests, researchers are exploring other biomarkers in urine, breath, and stool that may be linked to polyp formation. These non-invasive options could complement or, in the future, provide alternatives to traditional screening methods, particularly for individuals reluctant to undergo colonoscopy or those with access barriers.

While these innovations are still being validated and are not yet standard practice, they represent a significant step forward in making colorectal screening more accessible and patient-friendly. For updates on non-invasive detection research, visit the National Cancer Institute’s review on blood tests for colorectal cancer screening.

50. Advocating for Awareness and Action

Increasing public awareness about sessile colon polyps and their silent risk is crucial for preventing colorectal cancer. Many people remain unaware of the importance of screening, the subtle nature of early symptoms, and the impact of lifestyle choices on polyp development. Advocacy efforts—led by healthcare providers, patient organizations, and survivors—play a vital role in educating communities, influencing health policy, and reducing the stigma associated with digestive health issues.

Public education campaigns can dispel myths, encourage open conversations, and empower individuals to seek screening even in the absence of symptoms. Early action, such as adopting a healthy diet, increasing physical activity, quitting smoking, and reducing alcohol consumption, can further decrease polyp and cancer risk. Additionally, supporting policies that improve access to affordable screening and follow-up care can help close gaps for underserved populations.

Everyone can contribute to reducing the burden of colorectal cancer by sharing information, supporting loved ones through screening, and advocating for widespread prevention efforts. For resources on raising awareness and taking action, visit the CDC’s Colorectal Cancer Awareness Month page and the Colorectal Cancer Alliance’s advocacy resources.

Conclusion

Sessile colon polyps represent a silent but serious risk for colorectal cancer, often developing without symptoms and evading early detection. Recognizing their dangers and prioritizing regular screening are critical steps in reducing preventable deaths. Individuals should discuss their personal and family risk factors with healthcare providers and adhere to screening guidelines—starting as early as age 45 for average-risk adults. Adopting a healthy lifestyle, including a balanced diet, regular exercise, and avoidance of tobacco and excessive alcohol, further reduces risk. Increased awareness and proactive action can save lives. For more on prevention and screening, visit the American Cancer Society’s colorectal screening page.

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