Journal Mobile

JN Plevris
Journal Issue: 
Volume 35: Issue 1: 2005




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.