Endoscopic surveillance programmes for patients with Barrett′s oesophagus aim to detect high-grade dysplasia which may be a precursor to adenocarcinoma. However, Karen Bailey explains that before patients can be enrolled in a surveillance programme, they need to be made aware of the potential harms of surveillance, as well as the realistic chances of cancer developing. Patients need to be given simple, accessible and balanced information in order to make informed choices as to participation in surveillance or screening programmes for any condition. Health professionals also need to have an understanding of patients′ perceptions of surveillance and screening programmes and respect the informed decisions made by patients.