Inclusion Criteria:  Average risk subjects undergoing their first colonoscopy (screening) or follow-up colonoscopy for previous history of polyps (surveillance interval of 3 years or greater) Patients aged 45 or older Patients who can provide an informed consent  Exclusion Criteria:  Patients with history of colon resection, Inflammatory Bowel Disease (IBD), Familial Adenomatous Polyposis (FAP), severe comorbidity, including end-stage cardiovascular/pulmonary/liver/renal disease Patients who are pregnant or are planning pregnancy during study period Patients who are not able to or refuse to give informed consent