Colorectal polyps: pathophysiology, malignant potential, and advancements in therapeutic strategies

Colorectal cancer (CRC) is among the most common causes of cancer-associated death. The American Cancer Society predicts a significant increase in both the incidence and mortality of CRC over the next decade for individuals 54 years or younger. This prediction underscores the urgent need for effective screening and management strategies. CRC is the third most common type of non-skin cancer in both men (after prostate and lung cancer) and women (after breast cancer and lung cancer). In 2025, it is predicted that 693,452 people will be diagnosed with metastatic colorectal cancer. Colon polyps from both an adenoma and a serrated polyp have a significant risk of developing into CRC. This is why it is essential to correctly identify and manage sessile serrated lesions to help improve the quality and reliability of screening colonoscopy. The frequency of colonoscopies is determined by the size, number, and type of polyp found. If 1-2 polyps < 1 cm in size are removed, a colonoscopy in 5 years is appropriate. If the patient had 3-4 polyps < 1 cm in size or one polyp > 1 cm removed, a colonoscopy in 3 years is recommended. If five or more small or three or more large polyps are removed, then a 1-year colonoscopy is appropriate. To prevent colon cancer, it is recommended that patients get regular screening to help prevent and detect it. Some of the treatment options include laparoscopic and robotic surgical procedures, transanal minimally invasive surgery (TAMIS), hyperthermic intraperitoneal chemotherapy (HIPEC) surgery, and Intraoperative radiation therapy (IORT). Reviewing the previous literature on the management of colorectal adenomatous polyps and colorectal cancer, it becomes apparent that the various polyps need to be thoroughly categorized, and colorectal cancer needs to be screened for effectively, and then a proper management course needs to be set in place to maximize positive patient outcomes. Such a study will be very helpful for colorectal cancer specialists to manage patients with colorectal adenomatous polyps and colorectal cancer.