Purpose: Colorectal cancer and polyp screening has been accepted as the optimal screening test for average risk, asymptomatic subjects begining at age 50. Published studies concerning the results of screening colonoscopy are predominantly from VA/ University programs. However, given socioeconomic, racial and gender biases inherent to these studies, generalization of these results to general population remains unclear. The purpose of these study was to examine the endoscopic results of colorectal screening in an open access endsocopy facility dedicated to serve a large, non-profit, HMO in Southern Missouri. Methods: Consecutive colonoscopy screening examinations between 3/04 and 3/05 for asymptomatic subjects referred by their PCP were prospectively entered into database. Information captured at time of endoscopy included age, gender, family history of colon cancer/polyps, quality of preparation, success at reaching cecum, polyp size and location, coincident lesions detected, and immediate complications. Post procedure data captured included polyp histology, colorectal cancer stage, & polypectomy complications. All procedures were peformed by 8 experienced GI's with Olympus Colonoscopes (PCF-160AL, CF-Q160L). Polyps were considered advanced if TA ≥ 1 cm, with villous component, with HGD, or invasive cancer. Results: 2138 colonoscopies fullfilled criteria for asymptomatic screening for CRC (1037 M; 1101 F). Average age ± SD of 62.2 ± 9.2. 6% of cases were in subjects with one or more family members with CRC or polyps. Quality of colonoscopy prep was considered very good to excellent in 99.2%. The cecum was reached in 98.7%. No major complications (perforations, polypectomy bleeding, etc.) occurred. Non-adanced adenomatous polyp(s) were removed in 399 (18.7%). Advanced polyps were noted in 195 (9.1%) including 0.61% (13) with colon cancers (Ce/R/ HF 4, Tr 1, Left 3, Sig 3, Re 2). 3 patients had large sessile adenomatous polyps that required surgical resection. Additional significant findings included 2 small rectal carcinoids, 2 anal canal CIS lesions (surgically excised), 4 muscularis mucosa leiomyomas, 2 silent colonic IBD, and 1 pinworm infestation. Conclusions: Screening performed by GIs in an open acess community setting is characterized by high quality preps, cecal intubation rates > 98% and no major complications. Yields of non-advanced and advanced colonic polyps are significant and mirror that in VA/University settings.