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EDITOR’S NOTE: Physicians, providers, and administrative staff who practice at Maui Health hospitals and clinics answer questions from the public in "Healthwise Maui."Maui Health operates Maui Memorial Medical Center, Maui Memorial Medical Center Outpatient Clinic, Kula Hospital & Clinic, and Lana'i Community Hospital and accepts all patients. To submit a question, visit mauihealth.org/healthwise.
Q: Are polyps always precancerous? What happens if they find one during my colonoscopy?
Kimya Nguyen, DO, Gastroenterology, Pacific Permanente Group at Maui Memorial Medical Center Outpatient Clinic: Polyps are very common, and finding one during a colonoscopy doesn't mean you have cancer. Some polyps can eventually become cancerous, which is why getting regular screenings and removing them while they're small is important.
Depending on age and other factors, an estimated 15% to 40% of adults have colon polyps, growths that develop on the lining of the colon. There are several types of polyps; adenomas are the most common type with the potential to be cancerous.
Only about 5% to 10% of adenomas ever become cancerous. And even when they do, they usually develop over years, often a decade or longer, though timing varies. Catching polyps early and removing them during a colonoscopy can prevent cancer from developing at all.
If any polyps are precancerous, your doctor will recommend when to have your next colonoscopy. Depending on the type, size, and number of polyps, follow-up may be needed as soon as six months.
Occasionally, testing may show that a polyp your doctor removed already contains cancer cells. If that happens, your care team will determine whether additional testing or treatment is needed.
You can lower your risk of colorectal cancer by making healthy lifestyle choices, including eating a balanced diet with less red meat and processed or cured meats, maintaining a healthy weight, staying physically active, avoiding alcohol, and quitting smoking. It's also vital to keep up with regular screenings. Current guidelines recommend that adults at average risk begin colorectal cancer screening at age 45.
The bottom line is that catching and removing polyps early can significantly reduce your risk of colorectal cancer. Talk with your doctor about your individual risk and when screening is right for you. At Maui Health, our gastroenterology team provides comprehensive care for colorectal cancer screening, prevention, diagnosis, and treatment, as well as a wide range of digestive health conditions. To learn more, visit mauihealth.org/gastro.
Q: How does lack of sleep affect heart health?
Cameron Donaldson, MD, Interventional Cardiology, Pacific Permanente Group at Maui Memorial Medical Center Outpatient Clinic: Sleep doesn't just help you feel rested for the day ahead, it's also important for your heart. When sleep is short or restless, it raises the risk of conditions that strain the heart. In fact, research shows that people with insomnia have a 45% higher risk of cardiovascular disease. And new studies suggest that insomnia also increases risk for atrial fibrillation, an irregular heart rhythm.
There are several ways poor sleep affects the heart.
First, think about decision-making. When you're tired, you're less likely to make healthy choices. Insufficient sleep is linked to poorer impulse control, riskier decisions, and lower levels of physical activity. Over time, those patterns can increase the risk of conditions like obesity, high blood pressure, and diabetes.
But the impact is not just behavioral. Poor sleep also affects the body directly. During healthy sleep, blood pressure naturally drops, giving the heart a chance to rest. When you don't get enough sleep, that recovery period is shortened. In addition, sleep deprivation increases levels of cortisol and other stress hormones, which can raise heart rate, tighten blood vessels, and contribute to long-term cardiovascular risk.
You can improve your sleep and protect your heart by practicing good sleep hygiene. Try to keep a consistent sleep and wake time every day, even on weekends, and create a sleep environment that is cool, dark, and quiet. Limiting caffeine at least six hours before bedtime, turning off screens an hour before bed, and avoiding alcohol close to bedtime can also help improve sleep quality. It may also be beneficial to limit fluids in the two hours before bed to reduce nighttime bathroom trips and establish a relaxing bedtime routine, such as reading, stretching, or taking a warm bath.
Heart health starts with understanding your risk factors and making choices that support long-term wellness. If you have concerns about your heart health or symptoms you’d like evaluated, speak with your primary care provider or a cardiology specialist. To make an appointment with a heart specialist, call the Maui Memorial Medical Center Outpatient Clinic at 808-442-5700.