COLORECTAL CANCER SCREENING Surveillance guidelines after removal of colorectal

Most colon cancers are assumed to have a premalignantadenomatous polyp phase, therefore colonoscopic de-tection and polypectomy provides the opportunity for cancer prevention. Some patients who have undergone colonos-copy and have had adenomas removed are at increased risk of developing colorectal cancer (CRC) in the future, and therefore might benefit from colonoscopic surveillance. However, it is important to appreciate that colonoscopy is an invasive and costly procedure with some associated morbidity. It is also an under-resourced procedure in the UK, with a serious lack of fully trained endoscopists. Around one third of the population will develop an adenoma by age 60.Most adenomas are asymp-tomatic and remain undiagnosed. If colorectal screening is introduced this situation will change dramatically. There are few data on the benefits of colonoscopic surveillance in preventing colorectal cancer after a baseline clearing colono-scopy. It is therefore important that this practice is applied judi