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Your Colonoscopy Report: When to See a Genetic Counselor

Read Time: 3 minutes

Colon Cancer Anatomy

Most people need to get a colonoscopy every 10 years, starting at age 45. Everyone who gets a colonoscopy also gets a report. If there were no polyps, your report will state normal or negative. This means you are good to go for another 10 years, if nothing else about your health or symptoms change.

These are times when you may need a colonoscopy sooner or more often. These are also signs that you may benefit from seeing a genetic counselor:

  • You were diagnosed with colon cancer at any age, and especially under age 50.
  • One or more of your close relatives—a parent, child, sibling, grandparent, aunt, or uncle, for example—had colorectal cancer.
    • Start colonoscopies at age 40 (or 10 years before the earliest colon cancer diagnosis in your family) and repeat the colonoscopy every 1-5 years.
  • You have a personal history of large or multiple polyps found during colonoscopy, no matter your family history.

If your doctor finds polyps during colonoscopy

Polyps begin in the inner lining of the colon wall as an overgrowth of cells. Some types of polyps are precancerous, meaning they have a higher chance of turning into cancer. If these precancerous polyps are left in the colon, they may become cancer over time. Most colon cancers start in polyps called adenomas.

During a colonoscopy, your doctor will remove any polyps and any surrounding tissue that looks abnormal. Your doctor will report the polyp number, size, and location:

  • In the proximal colon, including the ascending colon and the transverse colon
  • In the distal colon, including the descending colon and the sigmoid colon
Colon Cancer Anatomy

The tissue is sent to a pathologist. This specialist looks at the tissue under a microscope to determine the types of polyps and if any have become cancerous. The pathologist will provide the findings in the pathology report.

About the pathology report

The pathology report will give details about the type of polyps and total number found. You may be at a higher risk to develop colon cancer depending on these findings. If your report or the report of a close family member includes any of the following, we recommend a risk assessment from a genetic counselor:

  • Ten or more adenomatous polyps (also called tubular adenoma or villous adenoma)
  • Five or more sessile serrated polyps/lesions in the proximal colon to the rectum
  • Two or more rare type hamartomatous polyps, which can include juvenile polyps
  • Personal history of any adenomatous polyps, sessile serrated lesions, traditional serrated adenoma, or large hyperplastic polyps (greater than or equal to one centimeter)

If your pathology report finds cancer

The pathologist will also determine if any of the tissue removed during your colonoscopy is cancer. Sometimes the cancer is only within the polyp. If that happens, taking it out may be the only treatment you need. If the cancer has grown outside the polyp, talk with your doctor about the next steps.

How a genetic counselor can help

Genetic counseling can help you in these ways:

  • Give a personalized risk assessment with your personal and family history
  • Educate and coordinate any genetic testing to determine your specific risks of developing certain cancers
  • Interpret results of genetic testing and offer next steps for you and your family to reduce cancer risks
  • Create a plan for early cancer detection
  • Discuss and recommend risk-reducing options like lifestyle changes, therapies, and surgeries
  • Personalize a cancer screening schedule with a high-risk clinic team
  • Recommend personalized treatment options if you were to develop cancer
  • Present any clinical trials you may be eligible for

For more information, call Huntsman Cancer Institute’s Family Cancer Assessment Clinic at 801-587-9555.

Cancer touches all of us.