Includes bibliographical references (leaves 257-302). ; The Genetic and Endoscopic Surveillance Clinic provides predictive testing and life-saving colorectal cancer screening services to individuals with Lynch syndrome in the Western and Northern Cape provinces of South Africa. The risk of colorectal cancer is reduced by 50% and mortality is decreased by 65% with regular colonoscopic screening; however, the attendance rate at the clinic has been declining over several years. Concerns exist for those individuals undergoing screening at levels below the desired recommendations. It was thus opportune for a formal evaluation of both the surveillance and predictive testing programmes to be conducted to determine factors affecting the access, utilisation and satisfaction with the service, from the perspective of the service users.