Most colorectal cancers arise from which type of polyp?

Adenomatous polyps are recognized as the primary precursor to many colorectal cancers, especially when considering the long-term development of malignancy. These polyps are characterized by dysplastic changes in the epithelial cells, which have the potential to progress to cancer over time if left untreated. The transformation from an adenomatous polyp to colorectal cancer is a key part of the adenoma-carcinoma sequence, a well-documented pathway in the development of colorectal tumors.

In contrast, while hyperplastic polyps can occur within the colon, they are generally considered to have little to no risk for progression to cancer. Serrated polyps, especially sessile serrated adenomas, can also have malignant potential, but they represent a different pathway and are not as commonly associated with the majority of colorectal cancers as adenomatous polyps. Inflammatory polyps arise from conditions like chronic inflammation or ulcerative colitis and are not precursors to cancer in the same way that adenomatous polyps are. Thus, the correct identification of adenomatous polyps as the main type associated with the development of colorectal cancer highlights their significance in cancer prevention and screening strategies.