← Issue №1/ week of Jun 24, 2026/Endoscopy

Computer-aided detection in surveillance colonoscopy: a population-based randomized trial.

From GI Signals issue №1: what this paper found, what it changes, and where it sits against the current standard of care, reviewed by Simon Mathews, MD.

Endoscopy rct · n=4,824 · Jun 28, 2026 · Endoscopy · IF 11.8

Computer-aided detection in surveillance colonoscopy: a population-based randomized trial.

New evidence
Clinical takeawayConsider CADe for endoscopists with lower baseline ADR (<54.5%) in surveillance colonoscopy, as it improves detection in this subgroup. For high-performing endoscopists, CADe does not provide additional benefit.
What it foundCADe did not increase overall adenoma detection rate (ADR) in surveillance colonoscopy (57.4% vs 58.8%; aRR 1.02 [95% CI 0.95-1.10]), but improved ADR among lower-performing endoscopists (ADR<54.5%) (45.5% vs 52.1%; aRR 1.15 [95% CI 1.01-1.30]).
ContextThis challenges the assumption that CADe universally improves ADR in surveillance colonoscopy, showing its benefit is limited to lower-performing endoscopists in a high-performing screening program.
Refinessuggested applicable standard· US Multi-Society Task Force on Colorectal Cancer (Gupta S, et al.), "Recommendations for Follow-Up After Colonoscopy and Polypectomy: A Consensus Update by the US Multi-Society Task Force on Colorectal Cancer," Gastroenterology, 2020

Decision at stakewhether to use computer-aided detection (CADe) in post-polypectomy surveillance colonoscopy

After polyp removal, assign the next colonoscopy surveillance interval using USMSTF 2020 based on polyp number, size, and histology (e.g., 1-2 tubular adenomas <10 mm 7-10 years; 3-4 tubular adenomas <10 mm 3-5 years; 5-10 tubular adenomas <10 mm, any adenoma ≥10 mm, or adenoma with tubulovillous/villous histology or high-grade dysplasia 3 years; >10 adenomas 1 year with polyposis evaluation; and for serrated polyps, 1-2 sessile serrated lesions <10 mm 5-10 years, 3-4 sessile serrated lesions <10 mm or a hyperplastic polyp ≥10 mm 3-5 years, and a sessile serrated lesion ≥10 mm or with dysplasia or a traditional serrated adenoma 3 years), and apply the shortest interval indicated when findings are mixed.

From our summary of this standard, unedited — the part the paper bears on. marks omitted text. Our wording, not the guideline's; read the source for its own text.

Our full summary of this standard

After polyp removal, assign the next colonoscopy surveillance interval using USMSTF 2020 based on polyp number, size, and histology (e.g., 1-2 tubular adenomas <10 mm 7-10 years; 3-4 tubular adenomas <10 mm 3-5 years; 5-10 tubular adenomas <10 mm, any adenoma ≥10 mm, or adenoma with tubulovillous/villous histology or high-grade dysplasia 3 years; >10 adenomas 1 year with polyposis evaluation; and for serrated polyps, 1-2 sessile serrated lesions <10 mm 5-10 years, 3-4 sessile serrated lesions <10 mm or a hyperplastic polyp ≥10 mm 3-5 years, and a sessile serrated lesion ≥10 mm or with dysplasia or a traditional serrated adenoma 3 years), and apply the shortest interval indicated when findings are mixed. Confirm complete resection and adequate prep before applying an interval, and use site-check/tumor-board pathways for piecemeal resection and malignant (T1) polyps. Refer for genetic evaluation when Lynch, FAP/AFAP/MAP, or serrated polyposis syndrome criteria are met.

US Multi-Society Task Force on Colorectal Cancer (Gupta S, et al.), "Recommendations for Follow-Up After Colonoscopy and Polypectomy: A Consensus Update by the US Multi-Society Task Force on Colorectal Cancer," Gastroenterology, 2020 · reviewed 2026-07-23 ↗
Codesido-Prado L … Cubiella J · Endoscopy · IF 11.8 · PubMed ↗Permalink
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