This is a scholarly monograph written by a surgeon who has devoted 26 years of consistent study to his subject. As expected, it is detailed, fact filled, and thorough. Many of its major themes such as the relation of polyps to cancer, the pathology and epidemiology of the lesions, and preoperative bowel preparation refer to original work by the author. Every subject and each chapter is annotated in detail and herein lies some of its value. Surgeons, pathologists, radiologists, and medical oncologists will all find this a meticulous source of reference and fact. Spratt is a numbers man, with a clear logical approach to his subject with no unsupported statements. Several of the sections deserve special comment. As one of the pioneer explorers of surgical decision trees, the chapter on the logic of managing colonic polyps and another on decisions in established cancers are classics. The algorithms are punctiliously correct,