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World J Gastroenterol. Jul 21, 2026; 32(27): 118009
Published online Jul 21, 2026. doi: 10.3748/wjg.118009
Published online Jul 21, 2026. doi: 10.3748/wjg.118009
Performance of computer-aided diagnosis for colorectal sessile serrated lesions: A systematic review and meta-analysis
Song Zhang, Shi-Hang Wang, You-Dong Zhao, Jia-Hui Wei, Xiang-Yu Sui, Xin Li, Huan-Wei Zhang, Zhi-Yao Huang, Cheng-Long Wang, Hao Hu, Zhao-Shen Li, Sheng-Bing Zhao, Yu Bai, Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai 200433, China
Jing Zhang, Department of Pathology, Changzheng Hospital, Naval Medical University, Shanghai 200433, China
Co-first authors: Song Zhang and Shi-Hang Wang.
Co-corresponding authors: Sheng-Bing Zhao and Yu Bai.
Author contributions: Zhang S and Wang SH contributed equally, as they are co-first authors; Zhao SB and Bai Y contributed equally, as they are co-corresponding authors; Zhang S contributed to formal analysis, writing-original draft, writing-review and editing, investigation, software; Wang SH contributed to visualization, data curation, writing-review and editing, software, investigation; Zhao YD contributed to writing-original draft, data curation, software, investigation; Wei JH, Sui XY, Li X, Zhang HW, Huang ZY, Wang CL and Hu H contributed to data curation, investigation, visualization; Zhang J, Li ZS contributed to supervision; Zhao SB, Bai Y contributed to conception, conceptualization, methodology, project administration, resources, supervision, writing-review and editing.
Supported by The China National Postdoctoral Program for Innovative Talents, No. BX20230482; Shanghai Sailing Program, No. 23YF1458600; Noncommunicable Chronic Diseases-National Science and Technology Major Project, No. 2023ZD0501601; Shanghai Oriental Talents Program Top-Notch Project, No. BJKJ2025002; Chenguang Program of Shanghai Education Development Foundation and Shanghai Municipal Education Commission, No. 22CGA42; Special Clinical Research on Health Industry of Shanghai Municipal Health Commission, No. 20244Y0231; Natural Science Foundation of Shanghai, No. 23ZR1478700; Shanghai Eastern Talent Youth Program, No. QNWS2024100 and No. QNWS2024108; Shanghai Public Health Key Discipline Project, No. GWVI-11.1-21; Shanghai Medical Innovation Research Project, No. 23Y11902500; Shanghai Hospital Development Center Foundation, No. SHDC22025222; Changhai Hospital Special Foundation for Clinical Research Program, No. 2024 LYB05; and Changfeng Guhai Project of Changhai Hospital (Changying Youth Seedling Plan).
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Corresponding author: Yu Bai, MD, Doctor, Department of Gastroenterology, Changhai Hos
Received: December 22, 2025
Revised: January 26, 2026
Accepted: March 24, 2026
Published online: July 21, 2026
Processing time: 196 Days and 21.1 Hours
Revised: January 26, 2026
Accepted: March 24, 2026
Published online: July 21, 2026
Processing time: 196 Days and 21.1 Hours
Core Tip
Core Tip: This is the first meta-analysis to comprehensively evaluate the efficacy of computer aided diagnosis (CADx) systems in identifying sessile serrated lesions (SSLs). The meta-analysis demonstrated the limited differentiation performance of CADx systems for SSLs, which is also significantly inferior to the distinguishing ability of colonoscopists. Although CADx systems perform well in differentiating SSLs from non-SSLs with relatively high specificity, their sensitivity is far lower than that of the optical biopsy criteria, particularly for differentiating between SSL and hyperplastic polyp.