Computer-Assisted Colonoscopy in High–Adenoma Detection Rate Settings in a High-Risk Population

Does the use of computer-aided detection (CAD) during colonoscopy improve adenoma detection within high–adenoma detection rate (ADR) settings in the context of fecal immunochemical test (FIT)–based screening?In this randomized clinical trial of 1356 participants, CAD met noninferiority criteria for ADR. Significant increases occurred only in the exploratory FIT-positive subgroup, driven by detection of diminutive adenomas, and led to more intensive surveillance intervals based on US Multi-Society Task Force guidelines.CAD-assisted colonoscopy was noninferior to standard colonoscopy; however, detection gains involved mainly small lesions and increased intensive surveillance recommendations, while long-term clinical benefits remain uncertain.

Corresponding Author: Han-Mo Chiu, MD, PhD, Department of Internal Medicine, National Taiwan University Hospital, No. 7, Chung-Shan S Rd, Taipei, Taiwan (hanmochiu@ntu.edu.tw).

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