With the improvement of living standards and people’s health awareness, more and more people are willing to undergo gastroscopy, and many people even take the initiative to add this item in their medical checkups. And quite a number of people are found to have intestinal polyps during the examination, people may ask: Why do I have intestinal polyps without any symptoms? Can intestinal polyps become cancerous too? Is it necessary to remove them? I. What is intestinal polyp? Intestinal polyp is a bulging lesion on the surface of intestinal mucosa protruding into the intestinal cavity, which is a mass of hyperplastic tissue. The majority of intestinal polyps have no clinical symptoms and are only discovered incidentally during colonoscopy. If the polyp is large or accompanied by malignant changes, it may show symptoms such as blood in stool, diarrhea, constipation, abdominal distension and abdominal pain. Second, why do I have intestinal polyps? The reasons for the occurrence of intestinal polyps are complex and are currently related to age, dietary factors, inflammatory stimuli, lifestyle habits genetic and other factors. 1, age The incidence of colorectal polyps increases with age. Age > 50 years is a high risk factor for the occurrence of intestinal polyps. 2, chronic inflammation of the intestine colorectal mucosa in the long-term chronic inflammation of the continuous stimulation of inflammatory polyps, common in chronic ulcerative colitis, Crohn’s disease and amoebic dysentery, intestinal schistosomiasis and intestinal tuberculosis, etc., also seen in the anastomotic site after colon surgery. 3, diet The occurrence of colorectal polyps is related to high-fat, high-protein, low-fiber diet, and smoking is closely related to adenomatous polyps. 4, genetic abnormalities The absence or mutation of the APC allele oncogene in the long arm of the 5th chromosome, the gene appears to lose its inhibitory effect on the tumor, resulting in familial polyposis and cancer. 5.Heredity The occurrence of certain polyposis is related to heredity, such as familial non-polyposis colorectal cancer (HNPCC) and familial adenomatous polyposis (FAP). When someone in the family has adenomatous polyps, the possibility of colorectal polyps in other members is significantly higher, especially familial polyposis has obvious family heritability. 6.Embryonic abnormalities Juvenile polyposis is mostly misshapen tumors, which may be related to abnormal embryonic development. 7.Bile metabolism disorder After cholecystectomy or gastrojejunostomy, the bile flow and discharge time are changed, and the content of bile acid in the large intestine is increased and polyps are induced. Third, will intestinal polyps definitely become cancerous? Must they be removed? Different pathological types of polyps cause different consequences. Among them, adenomatous polyps are recognized as precancerous lesions and have certain risk of cancer, so they should be removed. 1, non-neoplastic polyps Juvenile polyps: the nature of the disease is a kind of misshapen tumor. Inflammatory polyps: polyps formed by the proliferation of intestinal mucosa under the stimulation of long-term inflammation, almost not malignant, some polyps can subside on their own after the disappearance of inflammatory stimulation, but long-term inflammatory stimulation may also induce cancer. 2.Adenomatous polyps Most of the intestinal polyps are adenomatous polyps, which are classified into tubular adenoma, villous adenoma, serrated adenoma and mixed adenoma according to the pathological histology. Adenomatous polyps are precancerous lesions, and the more the villous component is, the higher the chance of cancer. Adenomatous polyps do not go away on their own and are difficult to be eliminated by medication. They may become atypical hyperplasia or even cancerous after gradual enlargement. It takes about 5-15 years from the formation of adenomatous polyp to tumor, and it goes through a long process of normal mucosa – hyperplasia – adenomatous polyp – atypical hyperplasia – carcinoma. Most adenomatous polyps clinically contain mild heterogeneous hyperplasia, and a few are already severe heterogeneous hyperplasia. Therefore, once polyps are found, it is recommended to remove them as early as possible. D. How to review after the removal of intestinal polyps? After polyp removal is not a permanent solution, regular colonoscopy follow-up should be performed, and if new lesions or local recurrence are found, they should be dealt with in time. 1.For single benign polyp, it is recommended to review colonoscopy once a year after removal, and no polyp is found for 2 to 3 consecutive years, after which it can be changed to review colonoscopy once every 3 years. For multiple benign polyps, colonoscopy is recommended once a year. 2.For tubular adenoma with diameter <10mm and mild heterogeneous hyperplasia, follow the doctor's prescription for initial follow-up 2-3 years after polyp removal. For adenomas ≥10mm in diameter, with villous structure and severe heterogeneous hyperplasia, follow-up should be performed 3-6 months after polypectomy. 3. For patients with more than 10 adenomas found in 1 examination, the follow-up interval should be less than 1 year, and the possibility of potential family polyposis should be considered. For patients suspected to have hereditary non-polyposis colorectal cancer, follow-up should be strengthened, and at the same time, colonoscopy should be done for their relatives related by blood to exclude familial polyposis. 4. Patients with non-tip type polyps resected in blocks should be followed up in the following 3-6 months to verify whether the polyps were completely removed. The target population for colon tumor screening in China is those aged 50 years or older. Age over 50 years old, regardless of gender, symptomatic or not, and risk factors or not, should have a colonoscopy. High-risk groups such as first-degree relatives with a history of colorectal cancer, positive fecal occult blood, previous history of intestinal adenoma, and changes in bowel habits are recommended to undergo timely and regular colonoscopy, and the screening age can be advanced to 40 years old.