ABSTRACT
Colorectal cancer (CRC) is the third most commonly diagnosed cancer and the second leading cause of cancer death. The USA National Polyp study has demonstrated that, with careful colonoscopic surveillance, the incidence of CRC can be significantly reduced. Adenomatous polyposis is usually managed surgically, although the endoscopist may have an important role in diagnosis, in establishing a reasonable date for surgery according to the number and size of polyps, and subsequently in keeping the duodenum and rectum under review. Faecal occult blood testing, usually on an annual basis, is simple and cheap and has been proposed as an effective means of population screening. Barium enema has a low complication rate, and in experienced hands will detect most colonic cancers. Virtual colonoscopy is less sensitive than conventional colonoscopy for detecting small polyps. The aim of the endoscopist during colonoscopy is to scrutinize as much of the colonic mucosa as possible.
