1.   Only two patients were identified as having colonic neoplasia coexisting with upper gastrointestinal lesions.

2.   More recently a series of anecdotal reports suggested that colonic neoplasia might be missed in patients with upper gastrointestinal symptoms or lesions.

3.   Sixteen per cent of patients with benign upper gastrointestinal lesions had coincidental colonic neoplasia after excluding those with partial gastrectomies and upper gastrointestinal malignancy.

4.   Malignant disease, especially colonic neoplasia is rare in young subjects so investigations should be tailored to the patients age and the clinical setting.

5.   Biopsy specimens of normal colon were obtained from patients without any evidence of colonic neoplasia.