Evaluation of Gixam's Efficacy Predicting the Presence of Advanced and Non-advanced Colorectal Neoplasia in a FIT Negative Population

1. Participants aged ≥45 - ≤84 years.
2. Able to provide a signed informed consent.
3. Considered by a physician or healthcare provider as being of 'average risk' for CRC.
4. Scheduled for a screening colonoscopy at investigation site.

Exclusion Criteria:

1. Undergoing colonoscopy for investigation of symptoms.
2. Has undergone colonoscopy within preceding nine (9) years except for a failed colonoscopy due to poor bowel preparation. Failed colonoscopy must have been within the past year and without therapeutic intervention.
3. Positive FIT or Fecal Occult Blood Test (FOBT) result within the preceding eleven (11) months.
4. Positive Cologuard, Sheild, ColoSense or Epi proColon test within the preceding three (3) years.
5. History of colorectal cancer.
6. Family history of colorectal cancer, defined as having one or more first- degree relatives (parent, sibling, or child) with CRC at any age.

7. Participant has a diagnosis or medical / family history of any of the following conditions, including:

   • Familial adenomatous polyposis (also referred to as "FAP", including attenuated FAP and Gardner's syndrome)
   • Hereditary non-polyposis CRC syndrome (also referred to as "HNPCC" or "Lynch Syndrome")
   • Other hereditary cancer syndromes including but not limited to Peutz-Jeghers Syndrome, MYH-Associated Polyposis (MAP), Turcot's (or Crail's) Syndrome, Cowden's Syndrome, Juvenile Polyposis, Neurofibromatosis, or Familial Hyperplastic Polyposis.
8. Participant has a diagnosis or personal history of inflammatory bowel disease (IBD) including chronic ulcerative colitis and/or Crohn's disease.
9. Participants with a disability to extend their tongue.
10. Participants with tongue tremor.
11. Participants with tongue piercing.
12. Participants that had a dental visit in the 7 days prior to the Gixam test.
13. Participants that have taken antibiotics or anti-fungal medications in the 14 days prior to the Gixam test.
14. Participants that have taken probiotics in the 14 days prior to the Gixam test.
15. Participant is pregnant.
16. Participant has any condition that in the opinion of the Investigator should preclude participation in the study.