Colon polyps are precancerous lesions of colon cancer, and colonoscopy is the gold standard for their diagnosis and treatment, while missed colon polyps are associated with the occurrence of interstage colon cancer. High-quality colonoscopy retreat is closely related to reducing the rate of missed colon polyps and increasing the detection rate, and related measures include prolonged retreat time (≥6 minutes), adequate aspiration of food residues and fluid in the intestinal lumen, focusing on the proximal intestinal folds and intestinal curvatures, and repeated examinations. In this regard, Lee et al. from the Department of Internal Medicine, St. Mary’s Hospital, Daejeon, Korea Catholic University School of Medicine, conducted a prospective, multicenter, randomized study on the ADR of painless colonoscopy in a modified position and in a constant left lateral position, and the results were published in a recent issue of AJG Journal. Inclusion criteria were patients aged 45 to 80 years who were undergoing their first colonoscopy, and exclusion criteria included a history of colectomy, inflammatory bowel disease, colonic polyposis syndrome, skeletal muscle lesions, inability to obtain informed consent, unwillingness to be included in clinical trials, poor bowel preparation, and failure to reach the cecum during colonoscopy. Colonoscopy was performed by 17 endoscopists with the application of midazolam anesthesia and air insufflation, and patients were divided into a change of position group, where the former referred to a left lateral position for examination of the cecum, ascending colon, and hepatic flexure, a supine position for the transverse colon, and a right lateral position for the splenic flexure, descending colon, sigmoid colon, and rectum, and a continuous left lateral position for the latter. The primary study index was the adenoma detection rate, i.e., the proportion of patients with ≥1 adenoma. Secondary study indexes included polyp detection rate, mean number of adenomas per patient (MAP), MAP per bowel segment, and other indexes included age, sex, polyp volume, time to exit the scope, quality of bowel preparation, complications of colonoscopy, and histological type of polyps. Among them, the morphological typing of polyps was referred to the Paris classification criteria, and progressive polyps were defined as those with a volume ≥1 cm, containing a villous component, and severe heterogeneous hyperplasia/neoplasia. Finally, a total of 1072 eligible patients were included, including 536 patients in both the altered position group and the control group, with no significant differences in the basic parameters between the two groups. The number of polyps detected was 476 and 361, respectively, and the mean polyp sizes were 5.12 ± 0.16 mm and 5.37 ± 0.19 mm, respectively, and the proportions of flat (0-II) polyps were 31.% and 29.9 percent, with no significant difference between the two groups. The polyp detection rate and ADR were higher in the altered body position group than in the control group, and the progressive ADR was 8.0% and 6.5%, respectively, with no statistically significant difference. The MAP was also higher in the altered position group than in the control group, which was evident in the transverse colon and left hemicolectomy. In the study of the effect of changing position on ADR of endoscopists with different proficiency levels, it was found that ADR was elevated in 5 of the 7 specialists, with the most pronounced elevation in the low-ADR physicians; ADR was also higher in the other physicians in the changed position group than in the control group (36.7% vs. 22.4%). There was no significant effect of body position on the findings of the high-ADR endoscopists. Overall, experienced endoscopists had a higher ADR (39.5% vs. 29.6%), and there was no difference in ADR between patients with fair bowel preparation and those with good bowel preparation. In conclusion, changing position during colonoscopy is one of the easiest ways to improve bowel inflation without significant adverse effects and is suitable for most anesthetized patients. This study showed that changing the position at the time of exit during colonoscopy can improve ADR and MAP, with the most significant improvement in MAP in the transverse colon and left hemicolectomy, and endoscopists with low ADR can benefit from changing the position.