Tubular Adenomas

What are tubular adenomas?

Tubular adenomas are precancerous polyps in your colon. They’re often found during routine colonoscopies done to screen for colorectal cancer. Even though fewer than 9% of tubular adenomas become cancer, learning you have them might be like getting a very early warning you have a higher risk of developing colorectal cancer. That early warning could help you reduce your risk.

Are tubular adenomas the same as villous adenomas?

Seen under a microscope, both adenomas look like bumps in your colon lining or like tiny cauliflower heads clinging to a stalk. But tubular and villous adenomas have different growth patterns. Tubular adenomas have a regular growth pattern that looks like someone used your colon lining to create orderly rows of tiny test tubes. Villous adenomas look more like fronds from randomly placed ferns.

Understanding the different growth patterns helps healthcare providers to assess whether your adenomas are likely to become cancerous. For example, villous adenomas tend to grow more quickly than tubular adenomas and are more likely to become cancerous.

What causes tubular adenomas?

Anyone can develop tubular adenomas, but you’re at higher risk if:

• You smoke or use tobacco products.
• You have obesity.
• You are age 50 or older.
• You’re a man.
• You have a family history of cancer. If your parents, siblings or children have colorectal cancer, you’re twice as likely to develop colorectal cancer as someone who doesn’t have that history.
• Your medical history includes inflammatory bowel disease, previous colorectal cancer or ovarian cancer.
• You inherited certain gene changes. You’re more likely to develop rare forms of colorectal cancer such as familial adenomatous polyposis (FAP) or MUTYH-associated polyposis (MAP).

What are tubular adenoma symptoms?

Tubular adenomas rarely have symptoms. When they do, the most frequent symptom is finding painless bright red or dark red blood when you wipe yourself after pooping. Other symptoms are:

• Constipation or diarrhea.
• Unintentional weight loss.
• Loss of appetite.
• Stomach pain.

How do healthcare providers diagnose tubular adenomas?

Your healthcare provider might find a tubular adenoma while examining your rectum as part of a physical examination. But most tubular adenomas are found during colonoscopies done to screen for colorectal cancer.

What is the treatment for tubular adenomas?

The primary treatment is to remove your adenomas. This usually happens during the colonoscopy where healthcare providers discovered your adenomas. Providers typically use a wire loop or forceps to pull the adenoma loose from your colon lining. You might feel some pressure or pulling, but no pain. Your provider retrieves the adenoma so they can examine it under a microscope for cancer cells.

How can I reduce my risk of developing tubular adenomas?

Having tubular adenomas is a sign you might be at increased risk for colorectal cancer. There are many risk factors linked to colorectal cancer. Some of these you can change, and some you can’t. Here are steps you can take to reduce your risk:

• Cut back on the amount of alcohol that you drink.
• Stop smoking and using tobacco products.
• Attain a weight that's healthy for you.

What can I expect if I have tubular adenomas?

Tubular adenomas are precancerous polyps in your colon and rectum. They’re usually found during colonoscopies done to screen for colorectal cancer. If your healthcare provider finds tubular adenomas while performing your colonoscopy, you’ll probably need to have colonoscopies more frequently than someone who does not have tubular adenomas.

Will I always have tubular adenomas?

Tubular adenomas can recur, particularly if you smoke.

How do I take care of myself if I have tubular adenomas?

You’re already taking steps to care of yourself by having the colonoscopy that showed you have tubular adenomas. If you’re feeling anxious about your colonoscopy outcome, it might help to remember a few facts about tubular adenomas:

• Healthcare providers performing colonoscopies typically remove your tubular adenomas as part of the colonoscopy process.
• Approximately 90% of tubular adenomas don’t become cancerous.
• Having colonoscopies on a regular basis means you’ll know if you have new tubular adenomas providers can remove before the new adenomas can become cancerous.

When should I see my healthcare provider?

You should contact your healthcare provider any time you notice changes in your body that might be signs of new tubular adenomas or other problems that might be signs of colorectal cancer. Tubular adenomas rarely have symptoms. When they do, the most frequent symptom is finding painless bright red or dark red blood when you wipe yourself after pooping.

When should I go to the emergency room?

You should go to the emergency room if you have the following problems after your colonoscopy:

• Severe pain or cramping in your belly.
• A hard belly.
• Trouble passing gas or pooping.
• Fever.
• Dizziness.
• Vomiting.
• Frequent or severely bloody bowel movements.
• Rectal bleeding that won't stop or bleeding more than a couple of tablespoons.

What questions should I ask my doctor about tubular adenoma?

When your regular colonoscopy shows you have tubular adenomas, you might want to ask your healthcare provider the following questions:

• What is a tubular adenoma?
• Does this mean I have colorectal cancer or that I will have colorectal cancer?
• What is the treatment for tubular adenomas?
• Does this mean I have a genetic predisposition to colorectal cancer?
• How often should I have colonoscopies?
• What can I do to limit my risk of developing colorectal cancer?

A note from Cleveland Clinic

Tubular adenomas are a very early warning you’re at risk for colorectal cancer. Tubular adenomas aren’t cancerous and they aren’t likely to become cancer. But they are a sign you should consider learning what you can do to limit your risk of developing colorectal cancer. Ask your healthcare provider about steps you can take to limit your risk. They’ll be able to recommend helpful programs and services, whether that’s helping you stop smoking or to attain a healthy weight.