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Colonoscopy is now the investigation of choice for most patients with colonic symptoms, is essential for surveillance of patients at high risk for colorectal cancer (CRC), and for screening of the general population as a primary or secondary method. While colonoscopy performance and quality are different between endoscopists, it has also become clear that specific endoscopist quality parameters correlate with patient protection from developing cancer. Endoscopic image quality and definition has gradually improved since the inception of colonoscopy and will continue to do so into the future with increases in the quality and number of pixels in the CCD chip, enhanced processors, and ultra-high definition screen technology, perhaps also with 3D imaging. The world is at a tipping point in technological development with the introduction of artificial intelligence. The computing power to recognize, process, and give informed decision making, is penetrating all areas of society and rapidly entering the colonoscopy arena.