Use of a Distal Colonoscope Attachment to Increase Detection of Sessile Serrated Adenomas

Inclusion Criteria: * All patients who present to our outpatient gastroenterology suites for screening colonoscopy. Exclusion Criteria: * Age less than 45 and greater than 85 * Prior history of colon polyps (hyperplastic polyp, tubular adenoma or sessile serrated adenoma) and colon cancer * Patients with inflammatory bowel disease * Patients suspected to have colon cancer based on non-invasive tests such as stool tests for hemoglobin or DNA, or imaging finding suggestive of colon cancer (CT or barium enema). * Patients undergoing colonoscopy for evaluation of symptoms such as abdominal pain, rectal bleeding, diarrhea, constipation, etc., or patient with iron deficiency anemia suspected to be due to ongoing bleeding inside the colon * Patients with family history of colon cancer in 1st degree relative below the age of 60 * Patients with family history of hereditary polyposis syndromes such as Lynch syndrome, familial adenomatous polyposis etc., which are associated with an increased risk of colon cancer * Patients unable to consent * Pregnant patients * Incarcerated patients