{"id":30700,"date":"2026-07-07T04:18:00","date_gmt":"2026-07-06T20:18:00","guid":{"rendered":"https:\/\/csccm.org.cn\/?p=30700"},"modified":"2026-07-07T05:56:35","modified_gmt":"2026-07-06T21:56:35","slug":"jama-netw-open%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87%ef%bc%9a%e9%ab%98%e8%85%ba%e7%98%a4%e6%a3%80%e5%87%ba%e7%8e%87%e5%9c%ba%e6%99%af%e4%b8%8b%e5%af%b9%e9%ab%98%e5%8d%b1%e4%ba%ba%e7%be%a4%e7%9a%84","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=30700","title":{"rendered":"[JAMA Netw Open\u53d1\u8868\u8bba\u6587]\uff1a\u9ad8\u817a\u7624\u68c0\u51fa\u7387\u573a\u666f\u4e0b\u5bf9\u9ad8\u5371\u4eba\u7fa4\u7684\u8ba1\u7b97\u673a\u8f85\u52a9\u7ed3\u80a0\u955c\u68c0\u67e5"},"content":{"rendered":"\n

Original Investigation <\/p>\n\n\n\n

Gastroenterology and Hepatology<\/p>\n\n\n\n

Computer-Assisted Colonoscopy in High\u2013Adenoma Detection Rate Settings in a High-Risk Population: A Randomized Clinical Trial<\/h1>\n\n\n\n

Wen-Feng\u00a0Hsu,\u00a0Chen-Ya\u00a0Kuo,\u00a0Hsu-Heng\u00a0Yen,\u00a0et al<\/h3>\n\n\n\n

JAMA Netw Open 2026;9;(4):e264881.\u00a0doi:10.1001\/jamanetworkopen.2026.4881<\/h3>\n\n\n\n

Key Points<\/p>\n\n\n\n

Question<\/strong>  Does the use of computer-aided detection (CAD) during colonoscopy improve adenoma detection within high\u2013adenoma detection rate (ADR) settings in the context of fecal immunochemical test (FIT)\u2013based screening?<\/p>\n\n\n\n

Findings<\/strong>  In this randomized clinical trial of 1356 participants, CAD met noninferiority criteria for ADR. Significant increases occurred only in the exploratory FIT-positive subgroup, driven by detection of diminutive adenomas, and led to more intensive surveillance intervals based on US Multi-Society Task Force guidelines.<\/p>\n\n\n\n

Meaning<\/strong>  CAD-assisted colonoscopy was noninferior to standard colonoscopy; however, detection gains involved mainly small lesions and increased intensive surveillance recommendations, while long-term clinical benefits remain uncertain.<\/a><\/p>\n\n\n\n

Abstract<\/p>\n\n\n\n

Importance<\/strong>\u00a0\u00a0Computer-aided detection (CAD) systems can enhance adenoma detection, but their effectiveness in high-performance settings and among patients with positive fecal immunochemical test (FIT) results remains uncertain.<\/p>\n\n\n\n

Objective<\/strong>  To evaluate the impact of CAD on adenoma detection in routine practice, focusing on patients with positive FIT results.<\/p>\n\n\n\n

Design, Setting, and Participants<\/strong>  This multicenter, open-label, randomized clinical trial was conducted at 4 tertiary hospitals in Taiwan from February 23, 2022, to November 27, 2024. Adults aged 40 to 79 years who were scheduled for a colonoscopy owing to FIT positivity, symptoms, screening, or surveillance were randomized 1:1 to CAD-assisted or standard colonoscopy. Data were analyzed from December 1, 2024, to February 28, 2025.<\/p>\n\n\n\n

Exposures<\/strong>  Colonoscopy performed with a real-time CAD system or standard high-definition colonoscopy.<\/p>\n\n\n\n

Main Outcomes and Measures<\/strong>  The primary outcome was adenoma detection rate (ADR), defined as the proportion of patients with at least 1 histologically confirmed adenoma. Secondary outcomes included adenomas per colonoscopy (APC), sessile serrated lesion detection rate (SSLDR), and postpolypectomy surveillance intervals according to the US Multi-Society Task Force (USMSTF) and European Society of Gastrointestinal Endoscopy criteria.<\/p>\n\n\n\n

Results<\/strong>\u00a0\u00a0Of 1356 randomized participants (mean [SD] age, 60.0 [9.4] years; 678 [50.0%] female and 678 [50.0%] male), CAD-assisted colonoscopy met noninferiority criteria for ADR compared with standard colonoscopy (395 of 675 [58.5%] vs 363 of 681 [53.3%]; absolute difference, 5.2 percentage points [95% CI, \u22120.1 to 10.5 percentage points]). Superiority was not statistically significant. CAD significantly increased mean (SD) APC (1.41 [1.95] vs 1.20 [1.88];\u00a0P<\/em>\u2009=\u2009.01), driven mainly by detection of diminutive adenomas. In exploratory analyses of 864 patients with FIT-positive findings, CAD significantly increased ADR (288 of 441 [65.3%] vs 243 of 423 [57.4%];\u00a0P<\/em>\u2009=\u2009.02; adjusted odds ratio [AOR],\u20091.39 [95% CI, 1.05-1.86]) and APC (mean [SD], 1.64 [2.08] vs 1.39 [2.09];\u00a0P<\/em>\u2009=\u2009.01). SSLDR did not differ between groups. Consequently, CAD led to more intensive surveillance recommendations under USMSTF criteria, particularly in patients with FIT-positive findings (58 of 441 [13.2%] vs 31 of 423 [7.3%]; AOR,\u20091.94 [95% CI, 1.22-3.09]).<\/p>\n\n\n\n

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Conclusions and Relevance<\/strong>  In this randomized clinical trial, CAD-assisted colonoscopy met noninferiority criteria for adenoma detection. Superiority was not statistically significant overall, with significant improvements limited to the exploratory FIT-positive subgroup, driven largely by diminutive adenomas. CAD also increased intensive surveillance assignments. The incremental benefit of CAD in reducing interval cancer risk requires further investigation.<\/p>\n\n\n\n

Trial Registration<\/strong>  ClinicalTrials.gov Identifier: NCT03842059<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

Original Investigation  Gastroenterology and Hepat […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/30700"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=30700"}],"version-history":[{"count":1,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/30700\/revisions"}],"predecessor-version":[{"id":30701,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/30700\/revisions\/30701"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=30700"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=30700"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=30700"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}