Colon polyps classification

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sadaf Sharfaei M.D.[2]


Colon polyps may be classified into two groups of neoplastic and non-neoplastic. Non-neoplastic polyps consist of inflammatory and hamartomatous polyps. Neoplastic polyps consist of serrated and adenomatous polyps. Adenomatous polyps may be classified into several subtypes based on endoscopic and histologic features, and degree of dysplasia. Adenomas may be classified according to endoscopic features into four groups including sessile, pedunculated, flat, or depressed. Adenomas may be classified according to histologic features into three groups including tubular, tubulovillous, and villous.


Colon polyps may be classified according to the NBI International Colorectal Endoscopic (NICE) classification into two types:[6][7]

NICE criterion Type 1 Type 2
Color Same or lighter background Darker background
Vessels None, or isolated lacy vessels coursing across the lesion Brown vessels surrounding the white center
Surface Circular pattern with dark or white small spots surrounded by lighter mucosa Oval, tubular, or branched white structures
Probable pathology Hyperplastic Adenoma

Colon polyps may be classified according to malignancy potentials into two large groups:

Adenomas may be classified according to endoscopic features into four groups:

Adenomas may be classified according to histologic features into three groups:

  • Tubular
  • Villous
  • Tubulovillous

Adenomas may be classified according to degree of dysplasia into two groups:


  1. Shussman, N.; Wexner, S. D. (2014). "Colorectal polyps and polyposis syndromes". Gastroenterology Report. 2 (1): 1–15. doi:10.1093/gastro/got041. ISSN 2052-0034.
  2. Li SC, Burgart L (2007). "Histopathology of serrated adenoma, its variants, and differentiation from conventional adenomatous and hyperplastic polyps". Arch. Pathol. Lab. Med. 131 (3): 440–5. doi:10.1043/1543-2165(2007)131[440:HOSAIV]2.0.CO;2. PMID 17516746.
  3. Bonnington, Stewart N (2016). "Surveillance of colonic polyps: Are we getting it right?". World Journal of Gastroenterology. 22 (6): 1925. doi:10.3748/wjg.v22.i6.1925. ISSN 1007-9327.
  4. Ponugoti, Prasanna; Lin, Jingmei; Odze, Robert; Snover, Dale; Kahi, Charles; Rex, Douglas K. (2017). "Prevalence of sessile serrated adenoma/polyp in hyperplastic-appearing diminutive rectosigmoid polyps". Gastrointestinal Endoscopy. 85 (3): 622–627. doi:10.1016/j.gie.2016.10.022. ISSN 0016-5107.
  5. O'Brien, Michael J. (2007). "Hyperplastic and Serrated Polyps of the Colorectum". Gastroenterology Clinics of North America. 36 (4): 947–968. doi:10.1016/j.gtc.2007.08.007. ISSN 0889-8553.
  6. Hewett, David G.; Kaltenbach, Tonya; Sano, Yasushi; Tanaka, Shinji; Saunders, Brian P.; Ponchon, Thierry; Soetikno, Roy; Rex, Douglas K. (2012). "Validation of a Simple Classification System for Endoscopic Diagnosis of Small Colorectal Polyps Using Narrow-Band Imaging". Gastroenterology. 143 (3): 599–607.e1. doi:10.1053/j.gastro.2012.05.006. ISSN 0016-5085.
  7. Rameshshanker, R.; Wilson, Ana (2016). "Electronic Imaging in Colonoscopy: Clinical Applications and Future Prospects". Current Treatment Options in Gastroenterology. 14 (1): 140–151. doi:10.1007/s11938-016-0075-1. ISSN 1092-8472.

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