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Colonoscopy dominates colorectal cancer screening in the U.S. All guidelines recommend a 10-year colonoscopy interval for people at average risk for colorectal cancer who have a normal initial screening colonoscopy (i.e., no polyps or only diminutive rectosigmoid hyperplastic polyps), which accounts for approximately 75% of people screened. However, this proportion can be as low as 40% to 50% when colonoscopy is performed by colonoscopists with high detection rates. People with a negative screening colonoscopy have a substantially reduced risk for colorectal cancer (up to 80%) that has been shown to last up to 20 years (JW Gastroenterol Oct 14 2011). So, is it possible to use a test that is less expensive and risky than colonoscopy for foll…