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Colorectal cancer is the second leading cause of cancer death in the United States. Colonoscopy and polypectomy have been effective in reducing the incidence of colorectal cancer in cohort studies (1–3), a case control study (4), a randomized controlled trial (5), and a trial of fecal occult blood testing (6). Colonoscopy and polypectomy are becoming increasingly prominent tools in both the diagnosis and the prevention of colorectal cancer. Colonoscopy and polypectomy are complex technical procedures that require training and experience to maximize accuracy and safety (7). These recommendations for the technical performance of colonoscopy and for continuous quality improvement in colonoscopy were developed by the US Multi-Society Task Force on Colorectal Cancer, comprised of representatives of the American College of Gastroenterology, The American College of Physicians–American Society of …