Which type of polyps are most likely to develop into colon cancer?

Adenomatous polyps are considered precancerous lesions because they have the potential to undergo malignant transformation and develop into colorectal cancer. This type of polyp arises from the glandular tissues in the colon and can be characterized by dysplastic changes. The greater the degree of dysplasia present in adenomatous polyps, the higher the risk of progression to cancer. There are three main subtypes of adenomatous polyps: tubular, tubulovillous, and villous, with villous adenomas having the highest risk for cancer development.

In contrast, hyperplastic polyps are generally considered benign and have a very low risk of malignancy. Inflammatory polyps are typically associated with inflammatory bowel disease and do not have a direct link to cancer development. Sessile serrated adenomas have also been recognized for their potential to progress to colorectal cancer, particularly in the context of the serrated pathway, but adenomatous polyps remain the most well-established precursors for colon cancer. Understanding the characteristics and associated risks of different polyp types is crucial for effective surveillance and management in patients at risk for colorectal cancer.