Many people have hemorrhoids and are asked to have a colonoscopy when they visit the doctor – is this “superfluous”? Not really. Studies have shown that more than half of all colorectal cancers originate from adenomatous polyps. Our hospital has recently detected a number of elderly people with colon cancer through colonoscopy, and thanks to early detection, we were able to defuse the “time bomb” in time. Experts suggest that people over 40 years old should have a colonoscopy, which may save their lives. Adenomatous intestinal polyp is a precancerous lesion Intestinal polyp is a type of lesion in which the mucosal surface in the lumen of the large intestine is elevated, resulting in local hyperplasia. Zhang Wenxing, director of minimally invasive surgery at the First Affiliated Hospital of Hunan University of Traditional Chinese Medicine, said that intestinal polyps are divided into adenomatous, inflammatory and proliferative, among which proliferative intestinal polyps are related to intestinal cancer, while adenomatous intestinal polyps are most associated with colorectal cancer and are a “precancerous lesion”. The larger the adenomatous polyp, the greater the possibility of malignant transformation. According to the data, adenomatous polyps grow to 1~2 cm, the chance of cancer is 5%, and grow to more than 2 cm, the chance of cancer is about 25%~50%. The transformation of intestinal polyps into colorectal cancer is influenced by many factors, which may be the genetic mutation of the patient, or the patient’s long-term preference for frying, smoking, barbecue cooking methods, in addition to smoking, drinking, recurrent diarrhea, constipation, immune system decline due to excessive fatigue and other factors. Colonoscopy should be done over 40 years old No matter what kind of intestinal polyps, there is no discomfort in the early stage. This is because the width of the intestinal tract is 3-4 cm, and it can be expanded to accommodate the size of polyps. If the polyp causes blood in the stool, bloating, mucus stool and other symptoms, it means the polyp may have developed to the middle and late stage, or even the middle and late stage of colorectal cancer, which is often not felt in the early stage. There are four recent cases that impressed Zhang Wenxing: all of them were over 60 years old, and they were found to have polyps after colonoscopy for hemorrhoids or anal fistulas, and the polyps were found to be cancerous after biopsy. Therefore, he suggested that older people should not attribute all intestinal and perianal problems to “hemorrhoids”, but should always have a colonoscopy if they have bleeding stools or bloating. Colorectal cancer is mostly seen in people over 40 years old, and these people should have a colonoscopy if they have never had one before. Compared with pancreatic cancer and liver cancer, the survival rate of colorectal cancer is very high, and 90% of patients can be saved after timely detection and treatment, but in China, less than 10% can be detected at an early stage, which is related to the lack of colonoscopy. Many people reject to do colonoscopy because the examination may pull the intestine to cause discomfort and even pain, now there is a painless general anesthesia examination. Once a polyp is found in the intestine during colonoscopy, it should be removed regardless of the type. For polyps less than 2 cm can be removed directly by colonoscopic EMR (endoscopic mucosal resection); polyps larger than 2 cm can be considered for ESD (endoscopic mucosal dissection) removal, and if they cannot be removed under colonoscopy, tissue specimens can be taken for pathological examination first, and resection surgery can be done under laparoscopy on another day, and if there is cancer, it can be further expanded. Follow-up afterwards is also important, asking patients to come back for colonoscopy at 1 month, 3 months, 6 months, and a year, respectively, and then at 3-year intervals if there is no problem. This is because the intestinal tract is 1.5 to 2 meters long and there may be more than just one polyp, and the possibility of a missed diagnosis cannot be ruled out.