51.   Because of the high risk of developing a further cancer the patient was entered into the surveillance programme.

52.   Screening high risk individuals by colonoscopic methods is an established procedure, but identification is crude except for those few families with hereditary colorectal cancer.

53.   These studies show that if we can define a population with a high risk of recurrent disease then the outlook may be improved by medical treatment.

54.   Endoscopic stigmata of recent haemorrhage allow the identification of lesions with a high risk of rebleeding.

55.   High surgical risk patients without haemodynamic changes, had heater probe treatment and, if bleeding persisted or recurred, the patient was operated on.

56.   Thus heater probe treatment was considered an option for rescue treatment in high risk patients.

57.   A raised serum CRP has been explored as a prognostic index to define high risk patients and predict the course of the disease.

58.   In high risk patients, dilatation was initially done under fluoroscopic control, subsequently in most patients the procedure was done without the fluoroscopy.

59.   It is recommended that fluoroscopy be used for dilataion of these high risk patients to ensure proper positioning of the guidewire.

60.   In high risk populations such as those with a previous adenoma, the intervals between repeat colonscopy have been extended from one to three years.