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How villous adenoma relates to carcinoma

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Last Modified: November 24, 2002

Dear OncoLink "Ask The Experts,"
How are a villous adenoma and carcinoma thought to be related?  

Timothy C. Hoops, MD, Clinical Assistant Professor of Medicine in the Gastroenterology Division at the University of Pennsylvania and Director of Gastroenterology at Penn Medicine at Radnor, responds:

It is accepted that most, if not all, colon cancers begin as adenomatous polyps. This is a multistep process beginning with early polyps that then progress through several stages before eventuality transforming into frank cancers. Polyps progress in size as well as histology, i.e. what they look like under the microscope. Polyps are generally classified as tubular or villous. Villous means that they have small finger-like projections from the surface of the polyp. Villous adenomas are thought to be more advanced than tubular adenomas. Thus, they may be slightly "closer" to becoming cancers. I would stress, however, that they are still benign polyps and not cancers. In any case, if they have been removed, they should not cause any further problems. The only difference would be that you might perform a repeat colonoscopy a little earlier, say at 3 years rather than 5.