Inclusion Criteria:  Adult patients (>18 years) Referred and scheduled for diagnostic, screening (non-iFOBT based), or surveillance colonoscopy.  Exclusion Criteria:  Inflammatory bowel disease (IBD) Known polyp or tumor upon referral Therapeutic procedure (e.g., endoscopic mucosal resection) Prior surgical resection of any portion of the colon American Society of Anesthesiologists score of ≥3 Inadequately corrected anticoagulation disorder or anticoagulation medication use inability to provide informed consent.