Bowel polyps are small growths that form on the inner lining of the large bowel (the colon or rectum). They are very common — found in roughly 1 in 4 adults over 50 — and most cause no symptoms and are discovered by chance during a colonoscopy or screening. The vast majority of polyps are completely harmless. However, certain types — particularly a group called adenomas — have the potential to slowly turn into bowel cancer if left in place over time. Finding and removing polyps during a colonoscopy is one of the most powerful ways to prevent bowel cancer from developing in the first place.
Not all polyps are the same. The most important type to know about is the adenoma (also called an adenomatous polyp) — this is the kind that can gradually become cancerous if not removed. The risk depends on its size, how many there are, and what the cells look like under a microscope. Other types — like hyperplastic polyps or inflammatory polyps — are generally harmless. Sessile serrated lesions are a flatter type that can be harder to spot and do carry some risk; they need careful attention. Your specialist will explain exactly what type of polyp you have and what it means for you.
Most polyps cause no symptoms at all — which is why so many are discovered during routine screening rather than because something felt wrong. Occasionally, a large polyp may cause you to notice blood on the toilet paper, a change in bowel habits, or some mucus with your stools. But in most cases, there is nothing to feel. This is one of the reasons screening is so valuable — it finds things that you would never otherwise know are there.
A colonoscopy — a camera examination of your large bowel — is the best way to find polyps and remove them at the same time. Australia's National Bowel Cancer Screening Program (NBCSP) sends free home testing kits (called a faecal occult blood test, or FOBT) every two years — automatically from age 50 to 74, and on request for people aged 45–49. If your FOBT comes back positive, it does not mean you have cancer — but it does mean you need a colonoscopy to investigate. If you have a personal or family history of polyps or bowel cancer, speak with your GP about the right screening schedule for you — you may need to start earlier or be checked more often.
In most cases, polyps are removed right away during your colonoscopy. Small polyps are taken off with a simple technique called a polypectomy (using a tiny wire loop to snare and remove them). Larger or flatter polyps may need a more detailed technique called endoscopic mucosal resection (EMR) — where the surrounding tissue is lifted slightly to allow safer removal. Very large or technically complex polyps that cannot be safely removed by camera alone may require a more specialised approach — sometimes a minimally invasive surgical procedure called TAMIS (transanal minimally invasive surgery), or in rare cases a formal bowel resection. Every polyp that is removed is sent to a laboratory to be examined under a microscope, so you know exactly what was found.
After your polyps have been removed, you will need follow-up colonoscopies at certain intervals to make sure no new ones have formed. How often depends on the type, size, and number of polyps found at your last colonoscopy. Your plan will be personalised — you will be told exactly when your next check should be and why.
Mr Nguyen performs colonoscopy and polypectomy at Warringal Private Hospital and Epworth Eastern, and always aims to remove polyps completely and safely during the one procedure where possible — avoiding the need for further surgery. For polyps that are too large or complex for standard removal, EMR, TAMIS, or surgical resection are all available options. After your procedure, Mr Nguyen will give you a clear, personalised surveillance plan and explain exactly what was found, what type of polyp it was, and what that means for your future bowel health. There will be time to ask questions.
Please make an appointment if you have received a positive FOBT result, if you have a family history of bowel cancer or polyps, if you have noticed blood on the toilet paper or in the pan, or if your bowel habits have changed in a way that concerns you. Any of these things deserve a proper check — and most of the time the news is very reassuring.
Your GP will send a referral and most patients are seen within one to two weeks. At the consultation, a history is taken, any symptoms or screening results are discussed, and — in most cases — a colonoscopy is booked. Colonoscopy is done as a day case under sedation at Warringal Private Hospital or Epworth Eastern, and where polyps are found they are almost always removed during the same procedure.
Afterwards, you will be taken through exactly what was found, the histology results are shared with you once they are back, and a clear, personalised surveillance plan is written — including when your next colonoscopy should be. A copy of this plan goes to your GP so that nothing is lost to follow-up over the years.
No — most are not. The vast majority of polyps are completely benign (harmless). The ones that need attention are adenomas, which have the potential to become cancerous very slowly over time if not removed. Removing them is straightforward and very effective at stopping this from ever happening.
The process is very slow — it typically takes 5 to 15 years for an adenoma to develop into a cancer. This is actually reassuring, because it means regular surveillance colonoscopies have plenty of opportunity to catch and remove polyps long before they become a problem. You are not in a race against time.
Occasionally, a polyp is too large or awkwardly positioned to remove safely during a standard colonoscopy. In that case, you might be referred for a more specialised technique, a repeat procedure under different conditions, or in rare cases a minor surgical procedure. What is needed and why will be discussed with you.
In most cases, having a polyp does not mean your family members are automatically at risk. But certain inherited conditions — like Lynch syndrome or familial adenomatous polyposis (FAP) — can run in families and mean that relatives should also be screened. See the Familial Bowel Cancer Syndromes page for more on these. Whether this applies to your situation, and what to recommend to your family, will be discussed at consultation.
Have questions about bowel polyps?
Mr Nguyen sees patients at his consulting rooms in Heidelberg and operates at Warringal Private and Epworth Eastern. A GP or specialist referral is required.