For a study, researchers sought to look into colonoscopy outcomes and quality in the population-based New Hampshire Colonoscopy Registry after a positive mt-DNA test. They evaluated colonoscopy outcomes and quality between age-matched, sex-matched, and risk-matched individuals with and without a prior positive mt-DNA test from 30 endoscopy clinics. The main results were colonoscopy findings of CRC, advanced noncancerous neoplasia, nonadvanced neoplasia, or normal examination. Withdrawal time, bowel preparation quality, examination completion, and the percentage of average-risk adults with normal colonoscopies getting a USPSTF-recommended 10-year rescreening interval were all included in the quality assessments. Positive mt-DNA tests were substantially more likely than colonoscopy-only patients (N=918, 66.2 y; 61.8% female) to develop CRC (1.3% vs. 0.4%) or advanced noncancerous neoplasia (27.1% vs. 8.2%) (P<0.0001). After a positive mt-DNA test, 68.0% of patients had a colonoscopy (positive predictive value, 68.0%), compared to 42.3% of patients who only had a colonoscopy (P<0.0001). Between cohorts, there were no significant changes in colonoscopy quality parameters. After a positive mt-DNA test, Colonoscopy was linked to CRC and colorectal neoplasia more frequently than Colonoscopy alone. Positive mt-DNA testing can increase the number of colonoscopies with clinically important results. According to follow-up recommendations, endoscopists do not improperly decrease rescreening intervals in mt-DNA-positive individuals with normal Colonoscopy. These findings supported the clinical value of mt-DNA for CRC screening in community practice.