Colorectal cancer (CRC) is a highly prevalent disease which is associated with considerable mortality and morbidity rates; however, as the average span from precursor to malignant lesion is 15-20 years, there is quite a large window of opportunity for effective intervention and prevention. Colonoscopy is currently one of the most popular screening methods due to its sensitivity in detecting small adenomas and its therapeutic benefit from polypectomy, thus preventing subsequent CRC. This publication focuses on various aspects of CRC prevention and screening, starting with a discussion on how a genome fingerprint, coupled with an assessment of environmental risk factors, can help to identify subjects who will benefit the most from screening. A description of novel non-invasive screening tests, which are yielding very promising results owing to their high sensitivity and specificity, is followed by an evaluation of new colonoscopes currently being developed, and an update on the strengths and weaknesses of virtual colonoscopy. A discussion of the current state of chemotherapy and its future as well as of the importance of a combined approach of endoscopy and drug treatment in a high-risk population concludes the presentations.