Colonic Polyps: The Daily PANCE Blueprint
Which of the following is the most common type of premalignant colon polyp found on colonoscopy?
A. Serrated polyp
B. Hyperplastic polyp
C. Adenomatous polyp
D. Hamartomatous polyp
E. Inflammatory polyp
Answer and topic summary
The answer is C. Adenomatous polyp
Colon polyps are overgrowths of the colonic mucosa and are commonly detected on screening colonoscopy. Risk factors include diets high in red meat and fat, obesity, cigarette smoking, alcohol use, and genetic predisposition. Several histologic types exist, including adenomatous, inflammatory, serrated, hamartomatous, and hyperplastic polyps.
Among these, adenomatous polyps are the most common premalignant lesions and are the primary precursors to colorectal adenocarcinoma through the adenoma–carcinoma sequence. Adenomas are further classified as tubular, tubulovillous, and villous, with villous adenomas carrying the highest malignant potential. Diagnosis is confirmed by colonoscopy with biopsy.
Why the other choices are incorrect:
- Serrated polyps can be premalignant, particularly sessile serrated lesions, but are less common overall than adenomas.
- Hyperplastic polyps are typically benign and have minimal malignant potential.
- Hamartomatous polyps are associated with inherited syndromes and are not the most common premalignant type.
- Inflammatory polyps are usually seen in inflammatory bowel disease and are not inherently premalignant.
Board pearl: When asked for the most common premalignant colon polyp, think adenomatous → tubular most common, villous most dangerous.
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Smarty PANCE Content Blueprint Review:
Covered under ⇒ PANCE Blueprint GI and Nutrition ⇒ ⇒
Also covered as part of the Family Medicine Rotation topic lists
