Computer-Aided Water Exchange Colonoscopy With and Without Linked-Color Imaging for Detection of Clinically Significant Serrated Lesions

Inclusion Criteria: * Male and female patients aged 40-80 years scheduled for average-risk screening colonoscopy, post-polypectomy surveillance, diagnosis for gastrointestinal symptoms (including unexplained iron deficiency anemia and clinically significant diarrhea of unexplained origin), or referred for colonoscopy owing to a positive fecal immunochemical test (FIT) or guaiac fecal occult blood test (gFOBT) result. Exclusion Criteria: * familial adenomatous polyposis and hereditary non-polyposis CRC syndrome * personal history of serrated polyposis syndrome * personal history of CRC * history of inflammatory bowel disease * previous colonic resection * overt gastrointestinal bleeding * emergency colonoscopy or inpatients * planned EMR or ESD of large polyps * colon stricture or obstruction * contraindications to colonoscopy (eg, acute diverticulitis or toxic megacolon) * antithrombotic therapy precluding complete polyp resection * American Society of Anesthesiology classification of physical status \>3 * pregnant women or women planning pregnancy * refusal to provide a written informed consent