 Screening colonoscopy with removal of pre-cancerous adenomas was recently shown to result in a 53 reduction in mortality from colon cancer. While this clearly validates the practice of screening colonoscopy, missed adenomas, especially in the proximal colon, defined as including cecum, ascending colon, and transverse colon, remains a concern. This was demonstrated in a study of 183 patients who underwent back-to-back colonoscopies. In this population the overall miss rate for adenomas was 24 with proximal adenomas missed more often 27 than left colon adenomas 21. Another study looked at 4192 patients in the SEER Surveillance, Epidemiology, and End Results Medicare database who developed interval cancers, that is colon cancer in a patient who had a colonoscopy done in the previous 6-36 months. These interval cancers were predominantly in the proximal colon Proximal 68, Distal 19.5, rectum 10.4, and unspecified 2.1. This also suggests that pre-cancerous lesions are being missed in the proximal colon. As such a method that can increase proximal adenoma detection rate would be a welcome change. 