When should I screen for colorectal cancer?
In line with European Society of Gastrointestinal Endoscopy (ESGE) recommendations, organised colorectal cancer screening for average-risk adults targets people aged 50 to 75 years. ESGE recommends FIT-based population screening and notes that primary colonoscopy or sigmoidoscopy may also be appropriate depending on local factors, participation and endoscopy capacity.
This website deliberately identifies this as an ESGE recommendation, rather than presenting it as a South African national screening rule.
Screening can prevent cancer — not only find it earlier
Colorectal cancer is particularly suited to screening because precursor lesions can be identified and removed. ESGE's 2024 polypectomy guideline states that endoscopic removal of colorectal polyps reduces colorectal cancer incidence and mortality.
Who may need earlier or different assessment?
Age 50–75 applies to average-risk population screening. Family history, hereditary cancer syndromes, previous colorectal polyps or cancer, inflammatory bowel disease, previous abnormal tests and other risk factors may change the appropriate starting age, interval or test. These patients should be assessed individually.
Gastroscopy and upper gastrointestinal cancer prevention
Routine gastroscopy is not presented as universal population screening for every asymptomatic adult. Instead, upper-GI endoscopy is used according to symptoms and individual risk, and for surveillance of recognised conditions such as Barrett oesophagus or gastric precancerous changes. ESGE guidance supports high-quality endoscopic assessment and structured surveillance in defined risk groups.
When an abnormality is found
Modern endoscopy is not limited to diagnosis. Selected precancerous lesions and superficial early cancers of the oesophagus, stomach and colon can be treated endoscopically. Depending on lesion characteristics, treatment may include polypectomy, endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD). The aim is complete oncologically appropriate resection while avoiding major surgery when endoscopic treatment is suitable.
For patients
Request a gastroscopy or colonoscopy assessment
Self-refer for screening, surveillance or investigation. Your request is clinically reviewed before the procedure is confirmed.
Patient self-referral →For doctors
Direct endoscopy referral
Refer directly for gastroscopy, colonoscopy or both, with a separate pathway for advanced endoscopy.
Doctor referral →References & clinical guidance
- ESGE Position Statement — Role of gastrointestinal endoscopy in screening digestive tract cancers
- ESGE Guideline Update 2024 — Colorectal polypectomy and EMR
- ESGE Guideline — Diagnosis and management of Barrett oesophagus
- ESGE/EHMSG/ESP MAPS III 2025 — Gastric precancerous conditions and early neoplasia
The wording on this page is original. Recommendations are attributed to the source where used.
This information is educational and does not replace individual clinical assessment. A request for endoscopy is reviewed clinically before a procedure is confirmed.
Screening and advanced therapeutic gastroscopy and colonoscopy
Prof Noel performs gastrointestinal cancer screening and endoscopic removal of suitable colorectal and gastric polyps and selected superficial early cancers using endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD). His therapeutic practice also includes Z-POEM for selected Zenker’s diverticula, radiofrequency ablation for appropriately selected Barrett’s-related neoplasia, endoscopic stricture dilatation and other complex interventional procedures. Treatment is selected according to pathology, lesion characteristics and patient factors.