Inclusion Criteria:  Patients aged 18years or above Referred to endoscopy unit for diagnostic or surveillance colonoscopy  Exclusion Criteria:  Familial history of Familial adenomatous polyposis / Hereditary non-polyposis colorectal cancer Known history of inflammatory bowel disease Known colitis or suspicion of colitis (inflammatory bowel disease, diverticulitis, infective colitis) Emergency endoscopy of any nature (eg gastrointestinal bleeding, colonic decompression) Previous incomplete colonoscopy (not including insufficient preparation) / difficult colonoscopy Patients referred for a therapeutic procedure or assessment of a known non-resected lesion Patients with known palliative colorectal malignancy Patient with coagulopathy Patient with colostomy Patient with multiple co-morbidities (American Society of Anaesthesiologist >3) Inability to give informed consent