Can a Uterine Polyp Turn into Cancer?

Introduction

Other names:

• Uterine polyp
• Endometrial polyp
• Womb polyp

Uterine polyps are growths extending from the inner wall of the organ medically called the uterus into the uterine cavity. The inner lining of the uterus is called the endometrium, and overgrowth of cells in this layer leads to uterine polyps, also known as endometrial polyps. These polyps are usually noncancerous (benign), but some may be cancerous or eventually become cancerous [precancerous polyps].

Uterine polyps can range from a few millimeters to several centimeters (from a sesame seed to a golf ball) or even larger. They attach to the uterine wall by a broad base or a thin stalk.

You may have one or more uterine polyps. They usually remain inside the uterus but sometimes slip through the cervix into the vagina. Although they also occur in younger women, uterine polyps are most common during or after menopause.

Signs and symptoms caused by uterine polyps include:

• Irregular menstrual bleeding - for example, variable menstrual duration, frequent, heavy or unpredictable periods
• Bleeding between menstrual periods
• Extremely heavy menstrual periods
• Vaginal bleeding after menopause
• Infertility

Some women have only mild bleeding or spotting from uterine polyps; some polyps cause no symptoms or complaints.

When Should You See a Doctor for a Uterine Polyp?

• Vaginal bleeding after menopause
• Bleeding between periods
• Irregular menstrual bleeding

What Causes Uterine Polyps?

Hormonal factors appear to play a role. Uterine polyps are sensitive to estrogen, meaning they grow in response to circulating estrogen.

Risk Factors

Risk factors for developing uterine polyps include:

• Being perimenopausal (during the menopausal transition) or postmenopausal (after menopause)
• Having high blood pressure (hypertension)
• Obese being
• Tamoxifen use (a medicine for breast cancer)

What Problems Can Uterine Polyps Cause?

If uterine polyps occur at a young age, they may be associated with infertility. If you have uterine polyps and cannot have children, removing the polyps may allow you to become pregnant, but this procedure is not guaranteed to resolve infertility.

How Are Uterine Polyps Diagnosed?

If your doctor suspects uterine polyps, they may perform one of the following:

• Transvaginal ultrasound: A thin, wand-like device placed in the vagina emits sound waves and creates an image of the uterus, including its interior. Your doctor may see an obvious polyp or identify a uterine polyp as an area of thickened endometrial tissue.

A similar procedure is hysterography(also called sonohysterography). It involves saline (salt water) injected into the uterus through a small tube passed through the vagina and cervix. Saline expands the uterine cavity, allowing the doctor to see the inside of the uterus more clearly during ultrasound.

• Hysteroscopy: Your doctor inserts a thin, flexible, lighted camera (hysteroscope) through the vagina and cervix. Hysteroscopy allows your doctor to examine the inside of the uterus.
• Endometrial biopsy: Your doctor may use a catheter to collect a sample from the suspicious area, meaning a biopsy from inside the uterus. Uterine polyps may be confirmed by endometrial biopsy, but a biopsy can also miss a polyp.

Most uterine polyps are noncancerous (benign). However, endometrial hyperplasia (thickening of the uterine lining), uterine cancers (endometrial carcinoma) or certain precancerous changes may appear as uterine polyps. Your doctor will probably recommend polyp removal and send a tissue sample for laboratory analysis to make sure it is not uterine cancer.

- Related topic: Stages and Treatment of Uterine Cancer

How Are Uterine Polyps Treated?

• Follow-up / watchful waiting: Small polyps that cause no complaints may shrink or disappear on their own. Treatment of small polyps is unnecessary if you have no risk of uterine cancer.
• Medication: Certain hormonal medicines, including progestins and gonadotropin-releasing hormone agonists, may reduce polyp-related signs and symptoms. However, taking these medicines is generally a short-term solution at best - symptoms usually return when you stop taking them.
• Surgical removal: During hysteroscopy, instruments placed inside the uterus allow polyps to be removed. The removed polyp will probably be sent to a laboratory for microscopic / pathological examination.

If a uterine polyp contains cancer cells, your doctor will discuss the next steps in evaluation and treatment with you.

Rarely, removed uterine polyps can recur. If they recur, you may need further intervention.