Inclusion Criteria:

Group A

• Aged ≥30 years* and able to give informed consent

• Patients attending colonoscopy

  • Through Bowel Cancer Screening Programme (FIT positive, Bowelscope conversion, surveillance)

  • Through standard NHS care (most commonly due to iron deficiency anaemia, altered bowel habit, weight loss, rectal bleeding, planned polypectomy**, those referred on basis of family history, abnormal cross-sectional imaging, polyp surveillance or post CRC surveillance)

    • The age of 30 was chosen to ensure that this is a population likely to be enriched for colorectal neoplasia with neoplasia below this age uncommon **In those attending for planned polypectomy, the results from the initial colonoscopy and the endoscopy where the polypectomy is undertaken will be summated for purposes of calculating the neoplasia profile

(COLO-SPEED) Group B

• Any patient attending for colonoscopy and able to give informed consent
• ≥ 18 years old
• Patient from the North of England

Exclusion Criteria:

Group A

• Unable to give informed consent
• Known polyposis syndrome
• Previous total colectomy
• Known colonic stricture which would limit complete colonoscopy
• Attending for planned therapeutic procedure other than polypectomy, such as insertion of colonic stent
• Attending for assessment of known inflammatory bowel disease (IBD) activity or for IBD surveillance
• Patients currently recruited into an interventional CTIMP for CRC prevention*

COLO-SPEED (Group B) **

• Unable to give informed consent
• Not in a centre supported by COLO-SPEED infrastructure (North of England)