• The participant must have signed and dated an IRB-approved consent form that conforms to federal and institutional guidelines.

• Participants greater than or equal to 45 and less than 70 years of age at the time of colonoscopy.

• Participants with a first-time diagnosis of 1-2 non-advanced tubular adenomas (less than 10 mm without tubulovillous or villous changes or high grade or severe dysplasia) from the qualifying colonoscopy within 4 years prior to randomization.

• Sessile serrated polyps/adenomas, as long as they do not meet the criteria for advanced adenomas, will be considered as non-advanced adenomas.

• Qualifying colonoscopy must be a complete colonoscopy with visualization of the cecum and with adequate cleansing within 4 years prior to randomization.

• Complete excision of all observed polyps in qualifying colonoscopy

• Participants must be able to read or understand English or Spanish.