Polyps and Polyposis

[*]Colorectal cancer is an ideal disease for early detection and prevention because there is a clearly identifiable, and treatable, premalignant condition: the polyp. The delineation of the polyp-cancer sequence in the pathogenesis of colorectal malignancy has greatly influenced our current approach to this common problem. In this issue of Clinics in Colon and Rectal Surgery, we hope to thoroughly cover the polyp, from prevention to advanced operative management.

Polyp growth, from normal mucosa to invasive cancer, is discussed in detail, with specific emphasis on the genetic mutations seen in the polyp-to-cancer sequence. Familial adenomatous polyposis and its variants as well as the more unusual polyposis syndromes are succinctly covered in separate reviews. Because not all polyps are neoplastic, attention in this issue is given to the histologic features differentiating these non-neoplastic polyps. Along with the detailed descriptions of both neoplastic and non-neoplastic polyps is an excellent overview of their medical and endoscopic management. Although debate rages on as to the appropriate method and timing of cancer screening and polyp surveillance, recent data to guide these decisions are presented in a succinct and reader-friendly format. Because some polyps will be found to harbor an invasive malignancy, a sound rationale for their individual management is offered. Finally, techniques for operatively treating rectal polyps are discussed.

We thank the contributors for their hard work and obvious expertise in preparing these very readable reviews. We also express our sincere gratitude to Dr. Beck for giving us the opportunity to be guest editors for this timely and important topic.