โก Quick Summary
The European Society of Gastrointestinal Endoscopy (ESGE) has issued a position statement recommending the use of computer-assisted detection (CADe) during colonoscopy for colorectal cancer (CRC) screening and surveillance. This recommendation, based on expert consensus, highlights the potential benefits of CADe, despite the evidence being limited and the recommendation being classified as weak.
๐ Key Details
- ๐ Panel Composition: 19 European experts participated in the voting process.
- ๐ณ๏ธ Voting Outcome: 13 members (68.4%) voted in favor of CADe, while 6 (31.6%) opposed it.
- โ๏ธ Recommendation Strength: The recommendation is considered weak due to limited evidence and uncertainty.
- ๐ฉบ Patient Considerations: The recommendation reflects patient values and preferences regarding CADe assistance.
๐ Key Takeaways
- ๐ CADe technology utilizes artificial intelligence to assist in colonoscopy procedures.
- ๐ Potential Benefits: Limited reduction in colorectal cancer incidence and mortality.
- โ ๏ธ Risks: Increased rates of polyp overdiagnosis and additional colonoscopy surveillance may burden patients.
- ๐ก Patient Preference: Most informed patients may favor CADe assistance during colonoscopy.
- ๐ ESGE’s Position: The statement is informed by systematic reviews and modeling from the MAGIC Evidence Ecosystem Foundation.
๐ Background
Colorectal cancer (CRC) remains a significant health concern globally, necessitating effective screening and surveillance strategies. The integration of artificial intelligence in medical procedures, particularly colonoscopy, has emerged as a promising avenue to enhance detection rates and improve patient outcomes. The ESGE’s position statement aims to clarify the role of computer-assisted detection (CADe) in this context.
๐๏ธ Study
The ESGE convened a panel of experts to evaluate the use of CADe in colonoscopy for CRC screening and polyp surveillance. The panel’s discussions were guided by the BMJ Rapid Recommendation initiative and the MAGIC Evidence Ecosystem Foundation, which emphasize systematic reviews and patient-centered approaches to medical recommendations.
๐ Results
The voting results revealed a majority support for the use of CADe, with 68.4% of panel members endorsing its application during colonoscopy. However, the recommendation is characterized as weak due to the limited evidence available, which raises questions about the absolute benefits in reducing CRC incidence and mortality.
๐ Impact and Implications
The ESGE’s position statement on CADe in colonoscopy could influence clinical practice and patient decision-making. While the potential for improved detection exists, healthcare providers must weigh the benefits against the risks of overdiagnosis and increased surveillance. This balance is crucial for optimizing patient care and ensuring informed consent in screening processes.
๐ฎ Conclusion
The ESGE’s recommendation for CADe in colonoscopy highlights the evolving landscape of colorectal cancer screening. While the technology shows promise, the weak nature of the recommendation underscores the need for further research to establish its efficacy and safety. As we move forward, ongoing evaluation and patient engagement will be essential in harnessing the full potential of AI in healthcare.
๐ฌ Your comments
What are your thoughts on the use of computer-assisted detection in colonoscopy? Do you believe the potential benefits outweigh the risks? ๐ฌ Join the conversation in the comments below or connect with us on social media:
Use of computer-assisted detection (CADe) colonoscopy in colorectal cancer screening and surveillance: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement.
Abstract
This statement conveys the European Society of Gastrointestinal Endoscopy (ESGE) position on the use of computer-aided detection (CADe) with artificial intelligence (AI) during colonoscopy for colorectal cancer (CRC) screening or surveillance. The ESGE position is informed by the BMJ Rapid Recommendation initiative and the approach of the MAGIC Evidence Ecosystem Foundation; these include systematic reviews of currently available evidence, supplemented by microsimulation modeling and patient values and preferences, for the benefits and harms of AI CADe devices during colonoscopy.ESGE convened a panel of European experts for this Position Statement. On December 18, 2024, panel members voted on their preferred recommendation between two choices about CADe during colonoscopy for indications of CRC screening or polyp surveillance. Out of 19 eligible votes, 13 (68.4%) voted to recommend CADe for colonoscopy, and six panel members (31.6%) voted against. Therefore, the current ESGE statement is: RECOMMENDATION: The panel believes that most well-informed patients who have already decided to undergo colonoscopy for screening or surveillance would favor CADe assistance during colonoscopy. This is due to the potential benefits, although limited, of reduction in colorectal cancer incidence and mortality.This recommendation is weak, because the evidence is limited with considerable uncertainty of the evidence estimates, the absolute benefits for colorectal cancer incidence and mortality are small, and there is a patient burden associated with CADe (more polyp overdiagnosis and more colonoscopy surveillance).
Author: [‘Bretthauer M’, ‘Ahmed J’, ‘Antonelli G’, ‘Beaumont H’, ‘Beg S’, ‘Benson A’, ‘Bisschops R’, ‘De Cristofaro E’, ‘Gibbons E’, ‘Hรคfner M’, ‘Karsenti D’, ‘Laquiรจre A’, ‘Loly JP’, “O’Reilly SM”, ‘Pellisรฉ M’, ‘Grubelic Ravic K’, ‘Triantafyllou K’, ‘Tziatzios G’, ‘Valente R’, ‘Walter BM’, ‘Wiesand M’, ‘Lorenzo-Zรบรฑiga V’, ‘Gralnek IM’]
Journal: Endoscopy
Citation: Bretthauer M, et al. Use of computer-assisted detection (CADe) colonoscopy in colorectal cancer screening and surveillance: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement. Use of computer-assisted detection (CADe) colonoscopy in colorectal cancer screening and surveillance: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement. 2025; (unknown volume):(unknown pages). doi: 10.1055/a-2543-0370