Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver · 2026
Efficacy of artificial intelligence in detecting precancerous lesions among a colorectal cancer screening population undergoing surveillance colonoscopies in Italy: a randomized control trial (GENIAL-CO Follow-Up study).
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Spada Cristiano, Cesaro Paola, Fuccio Lorenzo, Salvi Daniele, Ferrari Clarissa, Barbaro Federico, Bizzotto Alessandra, Butitta Francesco, Gerardi Viviana, Lovera Mauro, Milluzzo Sebastian Manuel, Minelli Grazioli Leonardo, Olivari Nicola, Pecere Silvia, Piccirelli Stefania, Pugliano Cecilia Lina, Pesatori Eugenia Vittoria, Quadarella Alessandro, Tettoni Enrico, Zani Chiara, Ricciardiello Luigi, Costamagna Guido
Аннотация
BACKGROUND AND AIMS: Computer-aided detection (CADe) has demonstrated improved adenoma detection rate (ADR) in screening populations; however, its value in post-polypectomy surveillance colonoscopy remains unclear. This study evaluated CADe efficacy in enhancing detection metrics during surveillance colonoscopy within an organized colorectal cancer (CRC) screening program.
METHODS: In this multicenter randomized controlled trial, patients aged 50-74 scheduled for surveillance colonoscopy were randomized 1:1 to CADe-assisted or standard colonoscopy (SC). The primary endpoint was ADR. Secondary endpoints included advanced ADR, adenomas per colonoscopy (APC), sessile serrated lesion detection rate (SSLDR), and withdrawal time (WT).
RESULTS: Of 973 enrolled patients, 914 were included after excluding 59 with inadequate bowel preparation (CADe: 455 vs SC: 459). ADR and AADR did not differ significantly between groups (66.6%vs 61.0%, p = 0.160; 7.3% vs 6.3%, p = 0.263). APC was significantly higher in the CADe group (1.80±2.19 vs 1.32±1.75, p < 0.001), while SSLDR was comparable (17.1%vs 14.2%, p = 0.154). Mean WT was significantly longer with CADe (16.35±8.32 vs 14.52±7.24 min, p < 0.001).
CONCLUSIONS: CADe-assisted colonoscopy did not improve ADR or AADR in a CRC organized screening population undergoing surveillance colonoscopy, while significantly increasing WT.
METHODS: In this multicenter randomized controlled trial, patients aged 50-74 scheduled for surveillance colonoscopy were randomized 1:1 to CADe-assisted or standard colonoscopy (SC). The primary endpoint was ADR. Secondary endpoints included advanced ADR, adenomas per colonoscopy (APC), sessile serrated lesion detection rate (SSLDR), and withdrawal time (WT).
RESULTS: Of 973 enrolled patients, 914 were included after excluding 59 with inadequate bowel preparation (CADe: 455 vs SC: 459). ADR and AADR did not differ significantly between groups (66.6%vs 61.0%, p = 0.160; 7.3% vs 6.3%, p = 0.263). APC was significantly higher in the CADe group (1.80±2.19 vs 1.32±1.75, p < 0.001), while SSLDR was comparable (17.1%vs 14.2%, p = 0.154). Mean WT was significantly longer with CADe (16.35±8.32 vs 14.52±7.24 min, p < 0.001).
CONCLUSIONS: CADe-assisted colonoscopy did not improve ADR or AADR in a CRC organized screening population undergoing surveillance colonoscopy, while significantly increasing WT.