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Background/Aims: Patients may feel embarrassed during colonoscopy. Our study aimed to assess changes in patient preference, overthe past decade, for the sex of their colonoscopist. Methods: Prospective studies were performed at a single health center from July to September 2008, and from July to September2016. Subjects included colonoscopy patients (2008: 354, 2016: 304) who were asked to complete a questionnaire before colonoscopy. Results: In 2016, 69 patients (24.9%) expressed a sex preference, compared with 46 patients (14.6%) in 2008. By 2016, female patientpreference for a female colonoscopist had significantly increased to 95% (odds ratio [OR], 2.678; 95% confidence interval [CI], 1.418–5.057; p=0.002). In multivariate analysis, patient sex (OR, 4.404; p=0.000), patient age (OR, 0.977; 95% CI, 0.961–0.992; p=0.004), andyear of procedure (OR, 1.674; 95% CI, 1.028–2.752) were statistically significant factors in sex preference. Between 2008 and 2016,female patients preferred a female colonoscopist because of embarrassment. Male patients also preferred a male colonoscopist, and theprimary reason shifted from expertise to patient embarrassment (2008: 29%, 2016: 63%). Conclusions: Patients have an increased gender preference for the colonoscopist because of embarrassment. Taking this into accountcan increase patient satisfaction during colonoscopy.

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