First of all, it is stated that polyps in the intestine do not necessarily mean colon cancer, but it is also added that 80% of colon cancer develops from intestinal polyps, which means that intestinal polyps are very closely related to intestinal cancer. First of all, what is intestinal polyp? Intestinal polyp is an overgrowth of intestinal mucosa that forms a bulge into the intestine. In layman’s terms, it is a lump of flesh growing in the intestinal canal. The most common intestinal polyp is in the large intestine, especially in the rectum and sigmoid colon, and its size and diameter can range from 2 mm to more than 20 mm. Endoscopically, the polyps can be divided into cauliflower-like polyps, papillary polyps, bridging polyps, broad-based polyps, and polyps with tissues according to their appearance. Pathological biopsies are further divided into: adenomatous polyps, inflammatory polyps, misshapen polyps and hyperplastic polyps. Adenomatous polyps are the most common type, including tubular adenomas, villous adenomas, and mixed adenomas. Intestinal polyps are common, with an estimated 1 in 4 people having them, and they are more common in men than women. Why are intestinal polyps and intestinal cancer closely related? Intestinal polyps can be divided into non-neoplastic and neoplastic polyps, of which neoplastic polyps account for 70% to 80%. Non-neoplastic polyps mainly include proliferative polyps and polyps caused by inflammation, which usually do not turn into malignant tumors. In contrast, tumor polyps are commonly adenomatous polyps, which have about 10% chance of developing into intestinal cancer after a few years if left untreated. Statistics show that 80% of colorectal cancers evolve from colorectal adenomas. Intestinal polyps and intestinal cancer are particularly closely related, with a high incidence of intestinal cancer and intestinal polyps, for example, intestinal polyps and intestinal cancer are both high in the United States, and it is possible that intestinal polyps and intestinal cancer are low in African countries, but these immigrants from African countries, after immigrating to European countries, the next generation, there is a trend of increasing year by year. What kind of intestinal polyps are cancer-prone? The cancer rate of intestinal polyps is related to the type of tissue, size, location and age of the polyps. Generally speaking, adenomatous polyps have a higher cancer rate, with adenomas larger than 2 cm, the cancer rate is greater than 50%. If the polyps are large in size, polyps without a tip, polyps that are multiple, polyps that are flat, or polyps that are lobulated in four types of states are more likely to become cancerous. In terms of polyp site: adenomas in the rectum and sigmoid colon have the highest incidence and cancer rate, while the transverse colon has the lowest. In terms of polyp size: the cancer rate of adenomas below 1 cm is 1%-2%, that of adenomas between 1 and 2 cm is 10%-20%, and that of adenomas above 2 cm is 30%-60%. In terms of single or multiple adenomas: the cancer rate of single adenoma is 20% to 30%, and the cancer rate of multiple adenomas is 30% to 80%. From age: the cancer rate of polyps from 40 to 60 years old is 10%-20%, from 60 to 69 years old is 15%-25%, from 70 years old or older is >30%, and from 80 years old or older is >50%. In terms of pathological types: the carcinoma rate is 2%-6% for tubular adenoma, 10%-30% for villous tubular adenoma, and 20%-50% for villous adenoma, respectively. Generally, cancer of intestinal polyps is a long time process, at least 5 years, average 5-10 years. What should I do if I find intestinal polyps? Generally speaking, the principle of treatment for intestinal polyps is to remove them under colonoscopy as soon as they are found. Adenomatous polyps, such as choroidal adenomas, have a high risk of becoming cancerous, and if left untreated, they will become cancerous 100% of the time. Therefore, once the polyp is found to be a villous adenoma on pathological examination, it must be removed early. In contrast, familial polyposis is a disease with an important genetic relationship and is precancerous. If no treatment is done, the risk of developing into colorectal cancer is high and must also be actively removed. However, no matter what kind of colon polyps are found, once discovered, patients should not take them lightly and should take treatment measures or review them regularly to pay close attention to the dynamics of the lesions. For larger polyps causing obstruction or not suitable for endoscopic removal, as well as polyp malignancy with infiltration at the tip or the depth of cancer infiltration cannot be confirmed, surgical resection should be done. After removal of intestinal polyps, we cannot rest on our laurels, because the probability of regeneration and recurrence of adenomatous polyps after removal is high, and multiple polyps are easy to be missed, so we need to follow up closely after polypectomy. For single polypectomy, the colonoscopy should be reviewed once in the first year. If no polyps are found, the colonoscopy will be repeated every 3 years thereafter. Multiple adenoma resection, or polyp size more than 2 cm with atypical hyperplasia, requires follow-up review once every 3-6 months. If no intestinal polyp is found on the first review, the review will be changed to once every 1 year. If no intestinal polyp is found in 2 consecutive reviews, the colonoscopy will be repeated every 3 years thereafter.