Computer-assisted versus standard colonoscopy for adenoma detection in a population-based colorectal cancer screening program: a randomized clinical trial.
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Davila-Piñón Pedro, Díez-Martín Astrid I, Nogueira-Rodríguez Alba, Fdez-Riverola Florentino, Glez-Peña Daniel, Reboiro-Jato Miguel, De Castro Luisa, Fernández-De Castro Daniel, Vega Pablo, Galovart-Araguas Miguel Telmo, Soto Santiago, Alonso-Lorenzo Sara, Martínez-Turnes Alfonso, Pin Noel, Zarraquiños Sara, Remedios David, Sánchez-Gomez Cristina, Souto-Rodríguez Raquel, Baiocchi Franco, Iglesias-Varela María José, Ledo Alejandro, Tejido-Sandoval Coral, Rivas Laura, García-Morales Natalia, Rodríguez-De Jesus Antonio, Puga Manuel, Castiñeira-Domínguez María Belén, Fernández-Fernández Nereida, Germade-Martínez Arantza, Gonzalez-De La Ballina Enrique, Pérez-Medrano Indhira, López-Fernández Hugo, Cubiella Joaquín
Аннотация
METHODS: This multicenter randomized clinical trial included patients aged 40-79 years who underwent colonoscopy after a positive fecal immunochemical test (FIT) or for surveillance. Patients were randomized to either conventional or CADe-assisted colonoscopy. The primary end point was ADR. Secondary end points were detection rates for serrated lesions (SLDR), polyps (PDR), advanced adenomas (AADR), and advanced serrated lesions (ASLDR). We performed subgroup analysis according to indication, endoscopist ADR, and bowel cleansing. Effect estimates were reported as adjusted risk ratios (aRRs) and 95%CIs.
RESULTS: 857 patients were randomized and 827 were included in the analysis. Baseline characteristics were comparable between groups (mean age: 61.7 [SD 6.5]; male 490; positive FIT: 552). We did not find statistically significant differences between CADe-assisted and conventional colonoscopy for ADR (60.8% vs. 57.7%; aRR 1.05, 95%CI 0.94-1.17). No significant differences were observed for SLDR (8.8% vs. 7.2%; aRR 1.04, 0.65-1.64), PDR (69.6% vs. 68.8%; aRR 1.00, 0.91-1.10), AADR (23.6% vs. 24.4%; aRR 0.90, 0.71-1.14), or ASLDR (4.9% vs. 4.8%; aRR 0.93, 0.51-1.68). Subgroup analysis showed no significant differences.
CONCLUSION: In colonoscopies performed in a CRC screening program, CADe-assisted colonoscopy did not increase ADR compared with conventional colonoscopy.