Pólipos e Cancro do Cólon e Recto

introduction: colorectal cancer (crc) in non-smoking patients of both genders is the most frequent in usa, australia, new zeland and western europe. in portugal the crc is the leading cause of death from malignant tumor.the most common initial symptoms are rectal hemorrhage and changes in the intestinal transit. the survival rate within the ？rst ？ve years can be superior to 90%, providing the diagnosis is made at an early stage. therefore, screening is very important and should be based on risk grading. since most crc (95%) originate from adenoma - precursor lesion-, removing the adenomatous polyps reduces the cases of crc in 76% to 96%. consequently, colonoscopy plays an important role in polyps diagnosis and their removal by polypectomy. however, this tecnique has got some restrictions and complications, wich has led to new diagnosis and therapeutic methods. it is importantto follow the patients with polyps according to quite consensual guidelines. methods: between june 2004 and october 2008 1114 cases for colonoscopy were referred to us. after appropriate preparation, we have done the total colonoscopy (observed cecum in 95% of the cases), under anesthesia with propofol. results: polyps were diagnosed in 32.3% of the cases and 205 polypectomies were done. approximately 54% of the polyps were adenomatous. high-grade dysplasia was diagnosed in 5 cases and adenocarcinoma in 3 cases. the treatment of these cases requires collaboration with surgery. conclusions: the crc is a serious public health problem. colonoscopy is considered to be the gold standard method in screening the crc. it provides the opportunity to detect the pre-malignant lesion - adenoma- and its removal in good time, in spite of the limits of our knowledge about the biology of the polyps and of the crc. the results by different authors reveals the importance of the colonoscopy with polypectomy in crc prevention.