Endoscopy is a medical specialism that is actively recruiting new entrants. There is considerable demand for colonoscopists in the USA and the UK to meet the respective guidelines for colorectal cancer screening in the general population. In the USA, it is recommended that men and women aged 50 years and older get screened for colorectal cancer as many studies have shown that screening reduces mortality from cancer. Colorectal cancer is the second leading cause of death in the US: the American Cancer Society estimates that 148,300 new cases will be diagnosed in 2002.

Colonoscopy is now a mainstream procedure and is widely used as a screening and treatment tool for colorectal cancer and inflammatory bowel disease. As a result, the focus is now changing from developing new techniques to enhancing the efficiency and quality of fundamental techniques. There are three elements to this agenda: initial training, continuous quality improvement and patient empowerment.

The table of contents has been created with these three elements at the fore. It is an extremely comprehensive textbook aimed primarily at the experienced colonoscopist but the book will be an extremely useful manual of procedures - clinical, administrative and managerial - for everyone working in the Endoscopy Unit.