Making colonoscopy smarter with standardized computer-aided diagnosis
Menée auprès de 791 patients et 23 endoscopistes, cette étude évalue la performance d'une coloscopie avec diagnostic assisté par ordinateur pour distinguer un adénome d'un polype non néoplasique
As screening for colorectal cancer gains traction worldwide, initiatives to reduce costs and improve efficiency are increasing. These strategies should not reduce the effectiveness of the screening programs.
Most cases of colorectal cancer develop from adenomas or sessile serrated polyps, and removal of these lesions is recommended. However, hyperplastic polyps, especially if diminutive (<5 mm) and located in the distal part of the large bowel, are not associated with subsequent development of adenomas or colorectal cancer (1). Therefore, they do not have to be removed to reduce cancer risk. Leaving these polyps unresected would save time and expense; the annual cost of unnecessary polypectomy of hyperplastic polyps is estimated to be $33 million in the United States (2). Distal hyperplastic polyps are encountered frequently during colonoscopy but are not easily distinguished from adenomas. This difficulty may have 2 consequences, neither ideal. First, the endoscopist may choose to remove all rectosigmoid polyps, thereby increasing cost and the risk for complications (although the risk is extremely low). Alternatively, he or she may choose to remove only the polyps believed to be adenomas, potentially leaving intact adenomatous polyps mistaken for hyperplastic polyps.
Annals of Internal Medicine , éditorial, 2017