SURVEILLANCE FINDINGS IN HIGH-RISK PATIENTS AFTER BASELINE COMPUTER-ASSISTED DETECTION COLONOSCOPY: A PROPENSITY SCORE MATCHING ANALYSIS.

Abstract

Background and aims: The impact of CADe application on surveillance colonoscopy findings remains unknown. We compare surveillance colonoscopy findings in patients with high-risk lesions detected at baseline, with or without the application of CADe.

Methods: We included patients with high-risk baseline lesions and had undergone surveillance colonoscopy. High-risk baseline lesions included advanced adenoma, advanced serrated lesion, or three or more adenomas at baseline colonoscopy. Patients were divided into two groups according to baseline use of CADe (vs conventional), and matched by propensity score matching (PSM) in 1:2 ratio for surveillance interval, baseline characteristics and index colonoscopy findings. The primary outcome was metachronous advanced adenoma (AA) rate.

Results: Of 403 patients with high-risk baseline lesions and surveillance colonoscopy, 162 patients were included after PSM. In patients with baseline use of CADe, both the AA detection rate (11.1% vs 24.1%, p=0.05) and the number of AA per colonoscopy (0.1 vs 0.3, p=0.01) were significantly lower than those with conventional colonoscopy. Similar pattern was observed for detection rate of adenoma (44.4% vs 63.0%, p=0.02) and the mean number of adenomas detected per colonoscopy (adenoma: 0.6 vs 1.2, p=0.01). The cumulative incidence of patients with any metachronous adenoma or serrated lesion was significantly lower in patients with baseline use of CADe than conventional colonoscopy (log rank p=0.05).

Conclusions: Patients who had CADe use at baseline colonoscopy had significantly lower rates of metachronous lesions, including advanced adenoma, on surveillance colonoscopy.