Aims Our aims was to assess if lower levels of cleansing score than the optimal one (BBPS < 9, with score per segment ≥2) have a negative impact in ADR in medium risk patients.A quality colonoscopy that guarantees detection and resection of neoplasia is mandatory in colorectal cancer screening (CRC). There is controversy whether adequate cleansing (BBPS ≥ 6) can be considered sufficient in CCR screening colonoscopy (CCCCR). The adenoma detection rate (ADR) is the main quality parameter.