Impact of computer-aided polyp detection in screening and diagnostic colonoscopy: A multicenter randomized controlled trial

doi:10.3748/wjg.116893

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World Journal of Gastroenterology

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1007-9327

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Gastroenterol. Aug 7, 2026; 32(29): 116893
Published online Aug 7, 2026. doi: 10.3748/wjg.116893

Table 1 Baseline characteristics, per protocol population, median (interquartile range)/n (%)

	Overall, n = 409	Conventional colonoscopy, n = 205	CADe, n = 204
Age (years)	60 (52-68)	60 (52-67)	59 (52-68)
Female	207 (50.6)	100 (48.8)	107 (52.5)
Colonoscopy indication
Primary screening	99 (24.2)	53 (25.9)	46 (22.6)
Secondary screening	60 (14.7)	29 (14.2)	31 (15.2)
Surveillance	52 (12.7)	22 (10.7)	30 (14.7)
Diagnostic	198 (48.4)	101 (49.3)	97 (47.6)
Boston Bowel Preparation Scale score	8 (6-9)	8 (6-9)	8 (6-9)
Adverse events	0 (0)	0 (0)	0 (0)
Time to cecum (minutes)	10 (7-14)	10 (7-14)	10 (7-15)
Overall procedure time (minutes)	22 (18-30)	22 (18-30)	22 (18-30)

CADe: Computer-aided detection.

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Table 2 Detection rates by center, n (%)

	Policlinico, n = 119	Niguarda, n = 115	FBF, n = 97	Poliambulanza, n = 65	Cattinara, n = 13	P value
PDR	49 (41.2)	44 (38.3)	45 (46.4)	32 (49.2)	7 (53.9)	0.51
ADR	30 (25.2)	32 (27.8)	32 (33)	27 (41.5)	5 (38.5)	0.18
AADR	9 (7.6)	1 (0.9)	10 (10.3)	2 (3.1)	1 (7.7)	0.03
SSLDR	4 (3.4)	7 (6.1)	12 (12.4)	8 (12.3)	0 (0)	< 0.01

FBF: Fatebenefratelli; PDR: Polyp detection rate; ADR: Adenoma detection rate; AADR: Advanced adenoma detection rate; SSLDR: Sessile serrated lesion detection rate.

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Table 3 Polyp detection rate and adenoma detection rate: Conventional colonoscopy vs computer-aided detection overall and for the main indications, n (%)

		PDR		P value	ADR		P value
		CC	CADe	P value	CC	CADe	P value
Overall		93 (45.4)	84 (41.2)	0.39	66 (32.2)	60 (29.4)	0.54
Primary screening	99 (24.2)	21 (39.6)	18 (39.1)	0.96	15 (28.3)	13 (28.3)	1
Secondary screening	60 (14.7)	15 (51.7)	16 (51.6)	0.99	13 (44.8)	15 (48.4)	0.78
Surveillance	52 (12.7)	13 (59.1)	17 (56.7)	0.86	11 (50)	15 (50)	1
Diagnostic	198 (48.4)	44 (43.6)	33 (34)	0.17	27 (26.7)	17 (17.5)	0.12

PDR: Polyp detection rate; ADR: Adenoma detection rate; CC: Conventional colonoscopy; CADe: Computer-aided detection.

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Table 4 Polyp detection rate and adenoma detection rate of the two study arms among high-volume and low-volume endoscopists in the different centers, n (%)

Detection rate	Centers	LVE	CC	CADe	P value	HVE	CC	CADe	P value
Polyp detection rate	Policlinico	64 (53.8)	9 (25.7)	14 (48.3)	0.06	55 (46.2)	14 (56)	12 (40)	0.24
	Niguarda	32 (27.8)	3 (25)	6 (30)	0.76	83 (72.2)	21 (47.7)	14 (35.9)	0.28
	FBF	53 (54.6)	16 (55.2)	9 (37.5)	0.20	44 (45.4)	10 (47.6)	10 (43.5)	0.78
	Poliambulanza	30 (46.2)	6 (33.3)	6 (33.3)	0.36	35 (53.8)	11 (73.3)	9 (45)	0.09
	Cattinara	6 (46.2)	1 (33.3)	3 (100)	0.41	7 (53.8)	2 (66.7)	2 (50)	0.66
Adenoma detection rate	Policlinico	64 (53.8)	5 (14.3)	9 (31)	0.11	55 (46.2)	8 (32)	8 (26.7)	0.67
	Niguarda	32 (27.8)	3 (25)	6 (30)	0.76	83 (72.2)	14 (31.8)	9 (23.1)	0.38
	FBF	53 (54.6)	13 (44.8)	6 (25)	0.13	44 (45.4)	9 (42.9)	8 (34.8)	0.58
	Poliambulanza	30 (46.2)	4 (22.2)	5 (41.7)	0.26	35 (53.8)	11 (73.3)	7 (35)	0.03
	Cattinara	6 (46.2)	1 (33.3)	1 (33.3)	1	7 (53.8)	1 (33.3)	2 (50)	0.66

LVE: Low-volume endoscopists; HVE: High-volume endoscopists; CC: Conventional colonoscopy; CADe: Computer-aided detection; FBF: Fatebenefratelli.

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Citation: Tontini GE, Dioscoridi L, Salerno R, Aldinio G, Buonocore MR, Cesaro P, Conforti F, Consonni D, Cottone I, Dabizzi E, Mantia B, Monica F, Mutignani M, Olivari N, Picardi G, Salvi D, Scaramella L, Schettino M, Topa M, Vecchi M, Elli L. Impact of computer-aided polyp detection in screening and diagnostic colonoscopy: A multicenter randomized controlled trial. World J Gastroenterol 2026; 32(29): 116893
URL: https://www.wjgnet.com/1007-9327/full/v32/i29/116893.htm
DOI: https://dx.doi.org/10.3748/wjg.116893

Tontini GE, Dioscoridi L, Salerno R, Aldinio G, Buonocore MR, Cesaro P, Conforti F, Consonni D, Cottone I, Dabizzi E, Mantia B, Monica F, Mutignani M, Olivari N, Picardi G, Salvi D, Scaramella L, Schettino M, Topa M, Vecchi M, Elli L. Impact of computer-aided polyp detection in screening and diagnostic colonoscopy: A multicenter randomized controlled trial. World J Gastroenterol 2026; 32(29): 116893 [DOI: 10.3748/wjg.116893]

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