Endoscopy
Signal score, how each part rates
ActionabilityPrevalenceStakesEvidence strengthNovelty
See the full rubric →Computer-assisted versus standard colonoscopy for adenoma detection in a population-based colorectal cancer screening program: a randomized clinical trial.
Clinical takeawayCADe systems should not be expected to improve adenoma detection rates in screening practice. This trial found no benefit across all tested subgroups, including endoscopists with lower baseline adenoma detection and those with suboptimal bowel preparation.
What it foundComputer-aided detection (CADe) did not significantly improve adenoma detection rate compared to standard colonoscopy in a CRC screening program (60.8% vs 57.7%; adjusted risk ratio 1.05, 95% CI 0.94-1.17), with similar rates for serrated lesions, advanced adenomas, and polyp detection overall.
ContextThis RCT contradicts prior optimism that CADe would enhance detection in screening settings. In a diverse population-based program (mean age 62, two-thirds positive FIT cases, mixed endoscopist experience), standard colonoscopy without computer assistance remains the evidence-supported baseline.
Reinforcessuggested applicable standard· U.S. Multi-Society Task Force on Colorectal Cancer (Rex DK, Boland CR, Dominitz JA, et al.), "Colorectal Cancer Screening: Recommendations for Physicians and Patients From the U.S. Multi-Society Task Force on Colorectal Cancer," Gastroenterology, 2017
Decision at stakestandard colonoscopy without computer-assisted detection is appropriate for colorectal cancer screening
U.S. Multi-Society Task Force on Colorectal Cancer (Rex DK, Boland CR, Dominitz JA, et al.), "Colorectal Cancer Screening: Recommendations for Physicians and Patients From the U.S. Multi-Society Task Force on Colorectal Cancer," Gastroenterology, 2017 · reviewed 2026-07-23 ↗Begin average-risk colorectal cancer screening at age 45 using a patient-centered shared-decision modality choice, colonoscopy every 10 years (preferred) or annual FIT as Tier 1 options, with multi-target stool DNA every 3 years, CT colonography every 5 years, or flexible sigmoidoscopy every 5 to 10 years as Tier 2 alternatives. A positive stool-based test requires diagnostic colonoscopy, and stool tests should not be ordered for patients who would decline follow-up colonoscopy. Generally stop at age 75 with individualized decisions for ages 76-85 and no screening beyond 85.
Davila-Piñón P … Cubiella J · Endoscopy · IF 11.8 · PubMed ↗