We read with interest the study by ten Kate et al (Gut 2007;56:1198–201) concerning screening for small bowel tumours in patients with Lynch syndrome (LS) (hereditary non-polyposis colorectal cancer, HNPCC). They demonstrated an approximate 1 in 25 risk of developing small bowel cancer, very high compared to that in the general population. In the UK, on average, only 700 small bowel cancers1 are diagnosed every year compared to 36 000 colorectal cancers.2 In the past 12 …