Is it necessary to remove polyps?: An expert guide to prevention

September 26, 2025 •

4 min read

Approximately 75% of colorectal cancers begin as a benign polyp. Navigating a polyp diagnosis can be unnerving, and understanding your risks is the first step toward safeguarding your health. So, is it necessary to remove polyps, and how does medical guidance help protect you from future complications?

Quick Summary

Removal is often the safest path, particularly for precancerous types like adenomas, to prevent progression to cancer and alleviate symptoms. Depending on the polyp's type, size, and location, some benign growths may only require watchful waiting rather than immediate removal.

Key Points

Not All Polyps are Equal: The necessity of removal depends on the polyp type, with neoplastic types (like adenomas) carrying a risk of becoming cancerous.
Prevention is the Primary Reason: The main goal of removing precancerous polyps, especially in the colon, is to prevent them from developing into life-threatening cancer.
Removal is a Minimally Invasive Process: Most polyps are removed during a routine colonoscopy, a common and generally low-risk procedure called a polypectomy.
Polyp Characteristics Matter: The size, number, and type of polyps dictate both the urgency of removal and the subsequent follow-up surveillance schedule.
Asymptomatic Polyps Can Be Dangerous: Many polyps cause no symptoms until they have progressed to a more serious stage, highlighting the importance of regular screening.
Professional Guidance is Key: Only a healthcare provider can properly diagnose polyps and determine the appropriate course of action, which may include monitoring or removal.
Lifestyle Changes Reduce Risk: Maintaining a healthy diet, exercising regularly, and avoiding smoking can help reduce your overall risk of developing polyps.

What Exactly Are Polyps?

Polyps are abnormal growths of tissue that can develop on the lining of various organs throughout the body, most commonly in the colon, but also in the uterus, stomach, or nose. Though many are benign, or non-cancerous, some types possess the potential to become malignant over time, which is why they are considered a significant health concern. Polyps can be categorized into two main types: neoplastic and non-neoplastic.

Neoplastic vs. Non-Neoplastic Polyps

Neoplastic Polyps: These growths have the potential to become cancerous if left untreated. The most common types are adenomas and serrated lesions. Since it can take many years for these polyps to transform, early detection and removal through regular screening are highly effective for cancer prevention.
Non-Neoplastic Polyps: These are typically harmless and do not usually progress into cancer. This category includes hyperplastic polyps and inflammatory polyps. While generally benign, they may still be removed for diagnostic purposes or to address symptoms.

The Critical Factors for Polyp Removal

Deciding whether and when to remove polyps is not a one-size-fits-all approach. The necessity of removal is determined by several factors, including the polyp's type, size, and the patient's individual risk factors.

Prevention of Cancer

The primary and most critical reason for removing certain polyps is to prevent cancer. Most colon cancers start as a small, benign polyp, which gradually changes over many years. By identifying and removing precancerous polyps during routine screenings, such as a colonoscopy, physicians can effectively stop cancer before it ever has a chance to develop.

Symptom Management

Some polyps, even benign ones, can cause bothersome or even serious symptoms, prompting their removal. These symptoms can vary depending on the polyp's location but may include:

Rectal bleeding
Changes in bowel habits, such as chronic constipation or diarrhea
Abdominal pain or cramping
Iron deficiency anemia resulting from slow, chronic bleeding

Diagnostic Certainty

When a polyp is removed, it is sent to a laboratory for a biopsy to be examined by a pathologist. This analysis confirms the polyp's type, determines if it is cancerous or precancerous, and helps guide future screening recommendations. Without removal and lab analysis, the exact nature of the polyp often remains unknown.

Polyp Removal Procedures: An Overview

Removing polyps is a common, often minimally invasive procedure known as a polypectomy. The method used depends on the polyp's characteristics and location.

Polypectomy during Colonoscopy: For most polyps discovered during a standard colonoscopy, removal is done at the same time using small tools passed through the colonoscope. The polyp is typically snared and cauterized to prevent bleeding. This is an outpatient procedure, and most patients can return to their normal routine the next day.
Advanced Endoscopic Procedures: Larger or more complex polyps may require advanced techniques like endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD). These procedures allow for the removal of larger polyps in a less invasive manner than traditional surgery.
Surgical Intervention: In rare cases, such as when a polyp is too large, has signs of invasive cancer, or is in a hard-to-reach location, traditional laparoscopic or open surgery may be necessary.

Comparison of Common Polyp Types


Polyp Type	Cancer Risk	Typical Treatment	Key Characteristics
Adenomatous Polyps (Adenomas)	Considered precancerous; can become cancer over time.	Removal during colonoscopy is highly recommended.	Most common type; can be tubular, villous, or tubulovillous.
Hyperplastic Polyps	Very low risk of becoming cancerous.	Often monitored, but may be removed for larger sizes or if causing symptoms.	Typically small and located in the lower colon.
Serrated Polyps	Risk varies; sessile serrated lesions have a higher risk than traditional serrated adenomas.	Removal is generally recommended due to potential risk.	Can be challenging to detect and may be flat or serrated in appearance.

What Happens When Polyps Are Not Removed?

Ignoring a polyp can carry serious consequences, especially if it is a neoplastic type. As polyps grow and change over time, the risk of them developing into cancer increases. Leaving them untreated essentially leaves a potential cancer pathway open. Beyond the risk of malignancy, unremoved polyps can lead to ongoing bleeding, iron deficiency anemia, or, in rare cases, bowel obstruction. Early intervention by removing the polyp is the best method for preventing these health complications.

Follow-Up Care After a Polypectomy

After polyps are removed, the recommended follow-up schedule depends on the pathologist's findings regarding the polyps' type, size, and number. Your doctor will provide a personalized surveillance plan.

Low-Risk Findings: For a few small adenomas, a follow-up colonoscopy may be scheduled in 5 to 10 years.
Increased Risk Findings: If multiple or larger adenomas were found, surveillance might be needed in 1 to 5 years, depending on the specifics.
High-Risk Findings: In cases with many polyps, very large polyps, or certain advanced types, follow-up may be required within 6 months to 1 year.

Conclusion

In summary, while not all polyps are created equal, medical consensus overwhelmingly supports the importance of removing precancerous polyps to prevent colorectal cancer. By undergoing regular screenings and working closely with your healthcare provider, you can proactively manage your risk and stay ahead of potentially serious health issues. Early detection truly saves lives by intercepting the disease process at its earliest, most treatable stage.

For more detailed information on polyps and their treatment, consult an authoritative source such as the Mayo Clinic.

Frequently Asked Questions

No, it is not always necessary to remove every single polyp. The decision to remove a polyp depends on its type, size, and appearance. Neoplastic polyps, which have the potential to become cancerous, are almost always removed. Small, non-neoplastic polyps may sometimes just be monitored.

The main reason for polyp removal is to prevent cancer. Most colorectal cancers begin as a benign polyp that changes over many years. By removing the polyp early, physicians can stop the development of cancer before it starts.

If a polyp, particularly a precancerous type, is not removed, it may continue to grow and could eventually develop into cancer. Additionally, some polyps may cause symptoms like bleeding, which could worsen over time if left unaddressed.

No, having a polyp does not mean you have cancer. The vast majority of polyps are non-cancerous when they are discovered. However, certain types of polyps, like adenomas, are considered precancerous, meaning they have the potential to become cancerous over time.

The most common procedure is a polypectomy, which involves removing the polyp during a colonoscopy. For larger or more complex polyps, advanced endoscopic techniques like Endoscopic Mucosal Resection (EMR) or surgery may be necessary.

The follow-up schedule varies based on the pathology results. Factors like the number, size, and type of polyps removed will determine when your doctor recommends your next colonoscopy, which could be anywhere from one to ten years later.

Yes, it is possible for new polyps to develop over time, even after previous ones have been removed. This is why regular surveillance colonoscopies are important, especially for those with a history of polyps.

While many polyps are asymptomatic, larger ones may cause symptoms such as rectal bleeding, changes in bowel habits, or abdominal pain. These symptoms can be an indication that a polyp needs immediate attention.