In a routine sigmoidoscopy clinic a specially trained nurse practitioner examined 825 patients between the ages of 23 and 88 with a mean age of 59. Seventy-two patients were found to have polyps; only eight of these patients had a history of rectal bleeding. Seventy-nine percent of these polyps were above 25 cm or beyond the reach of the rigid scope. Three patients with polyps were found to have cancer in the polyp. None of these patients had noted rectal bleeding. Significantly, there was a 10.6% yield of positive pathology among patients 50 and over. The training of the nurse practitioner is described in the article.