Abstract
Hopes and Hypes for Artificial Intelligence in Colorectal Cancer Screening
Highlights
Five randomized controlled trials (RCTs) have shown that adenoma detection rates (ADRs) increase by about 50% with the use of computer-aided detection (CADe) and its related technologies[5,6]; Wang et al conducted both nonblinded and blinded RCTs in China,[7,8] and Repici et al proved the efficacy of CADe in an RCT involving multiple European centers.[9]
Lifetime prevalence of colorectal cancer is approximately 5%, but greater than 50% for adenomas.[16]. This means that most adenomas which are removed during colonoscopy screening would never have progressed to cancer
Most individuals who undergo adenoma removal during colonoscopy do not experience benefits, but are prone to harms and burdens such as higher cost for colonoscopy, more frequent colonoscopy surveillances, and treatment complications. This trend toward overdiagnosis is likely to be accelerated with more detection of small adenomas with the use of CADe
Summary
There is great interest in artificial intelligence (AI) in health care. As with many innovations in medicine, there is a fine line between potential benefits and harms with the use of AI. This is especially important for preventive services such as cancer screening, where the trade-off between benefits and harms is delicate and involves millions of individuals. This Commentary clarifies clinical challenges of AI in cancer screening programs and explores solutions that can enable its optimal implementation
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