Colorectal polyps are histologically classified as inflammatory, hamartomatous, hyperplastic or neoplastic (adenomas). Adenomas can develop into malignant adenocarcinomas, which result in 95% of colorectal cancers. Polyps can be detected and examined by endoscopy, where the size, pit pattern, shape (sessile or pedunculated) and elevation (protruded, superficially elevated, flat or depressed) of a polyp can be indicative of its type and cancer risk. Chromoendoscopy and the lifting sign technique can help in diagnosis. Histological examination of the shape (serrated or not), structure (tubular, villous or tubulovillous) and cell replication rates of polyp tissue can be effective at identifying dysplasia and cancer risk. Should a polyp develop into a carcinoma, the extent of its invasion through the colon wall can be classified by the Haggit and Kikuchi scales to inform prognosis and appropriate interventions. Endoscopy nurses have an important role in detecting and diagnosing polyps and thus preventing the development of colorectal cancers.

Cathy Walsh - Colorectal Clinical Nurse Specialist, Letterkenny University Hospital, Republic of Ireland