This project will lead to the development of a cost-effective video sigmoidoscope system for office-based primary care physicians. Areas of innovation include: improvement of ergonomics, cost reduction and simplification of cleaning. Four clinical sites will participate in this project, ranging from solo family practitioners to large clinics staffed with gastroenterologists. Ergonomic improvement will focus on an improved physical design and a more logical control mechanism. Cost reduction effects will include: developing a low-cost imaging sensor; designing a low-cost video processor (with light source); integrating the air, water and suction functions into one unit; and developing an inexpensive video photography system. These combined innovations will result in a state-of-the-art system attractively priced for the primary care physician market.