**1. Introduction**

210 Gastrointestinal Endoscopy

As we have explained, colonoscopy plays an important role in preventing colorectal carcinoma. In average risk populations for developing of cancer, it is one of the recommended screening strategies. In this population it has not yet been demonstrated which one is the most cost-effective strategy. What is unquestionable is the role of colonoscopy because of its therapeutic approach on the removal of lesions detected by other techniques or by its own. In high-risk populations, the only acceptable strategy is screening colonoscopy. The frequency of examinations is determined in each case by the particular risk of developing CRC. In some cases, such as patients with long-standing ulcerative colitis or individuals from families with Lynch syndrome, conventional colonoscopy is not enough, requiring using special techniques for endoscopic diagnosis, such as chromoendoscopy and magnification endoscopy.

Our thanks to Dr. Vincent Hernandez Ramirez for providing us the latest data on colorectal cancer epidemiology in our country, and to Dr. Maria Luisa de Castro Parga to transfer us some of her images. In addition, we would like to thank the whole team and staff of the Endoscopy Unit in our hospital. Without their knowledge and dedication, our work would

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**3. Conclusions** 

**4. Acknowledgment** 

be less productive.

**5. References** 

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751-70.

Colorectal cancer is one of the most common causes of cancer-related death in the western world (Jemal et al., 2009). Most non-hereditary colorectal cancers arise from benign adenomas (Morison et al., 1974). It has been reported that removal of adenomatous polyps reduces the risk of subsequent colorectal cancer by as much as 80% (Winawer et al., 1993). Therefore, detection and removal of colorectal adenomas, as well as of cancer in the early stages, is utmost importance in improving the prognosis of patients with colorectal cancer. Although colonoscopy is one of the most reliable methods for diagnosis of colorectal neoplasms, conventional colonoscopy could be improved by addressing some of its shortcomings.

In this article, the new and promising technologies that comprise image-enhanced endoscopy (IEE) are reviewed, and a new colonoscopic strategy that incorporates some of these techniques is proposed.
