An alarmingly rapid rise in adenocarcinoma at the level of the gastro-oesophageal junction and distal oesophagus has been noted over the past two decades l 2. Intestinal metaplasia (IM) is considered to be the main precursor lesion for such adenocarcinomas. The prevalence of IM at the level of the cardia or of (ultra)short (~2-3 cm) or long (>2-3 cm) segments of columnar metaplasia in the distal oesophagus in the general population is unknown, but may well be substantial. In patients evaluated endoscopically for reflux symptoms, columnar metaplasia may be detected in lo-15% 3 4 The risk of malignancy in oesophageal columnar metaplasia (Barrett’s oesophagus) is thought to be increased 30-120 fold compared to the general population 5-9. Given the low 5-year survival rate in patients with advanced oesophageal cancer, strategies for early detection have been developed. The rationale for such strategies can be found in the fact that patients who undergo surgery for superficial lesions that are limited to the mucosa or submucosa have a much more favourable prognosis with 60100% 5-year survival l”-12. Since superficial cancers only rarely give symptoms, detection of cancer at such an early curable state can only be achieved through surveillance of patients at risk. Implementation, therefore, of an endoscopic surveillance programme for patients in whom IM has been detected in the distal oesophagus or at the oesophagogastric junction seems a reasonable option.