Cancers of the GI tract are the most common cancers in Europe and the US. Surveillance is recommended in Barrett’s oesophagus, gastric atrophy, and inflammatory bowel disease. For Barrett’s oesophagus, 3–5-yearly endoscopic surveillance is appropriate. The natural history of colorectal cancer justifies screening the general population or certain high-risk groups. The most widely accepted screening method is FOBT followed by colonoscopy if the FOBT is positive. In patients with excised adenomatous polyps, repeat colonoscopy is recommended in 3 years if high risk and 5 years if low risk. Surveillance is justifiable up to 75 years of age if there is no significant co-morbidity. Colonoscopic surveillance in inflammatory bowel disease starts 10 years from diagnosis for pancolitis and 15 years from diagnosis for left-sided colitis; thereafter every 3 years. Asymptomatic patients with strong family history of colorectal cancer should be referred to a clinical geneticist for risk assessment prior to colonoscopy screening.
