P0337 - The Impact of CADe on Sessile Serrated Adenomas Detection Rate During Colonoscopy

Cynthia Contreras, MD¹, Cesar Ortiz, MD², Paola Peña, MD², Ana Finke, MD², Sarah Herrera, MD², Maria Alonso, MD³, Nicole Peña, MD², Fernando Contreras, MD^2
1TriHealth, Cincinnati, OH; ²Centro de Gastroenterologia Avanzada, Santo Domingo, Distrito Nacional, Dominican Republic; ³Centro de Gastroenterologia avanzada, Santo Domingo, Distrito Nacional, Dominican Republic

Introduction: Sessile Serrated Adenomas (SSA) are typically flat, pale, and ill-defined growths coated in mucus often found in the right colon, making them hard to identify. They are a well-understood precursor lesion in the development of Colorectal Carcinoma (CRC) and interval carcinomas. Hence, improving the detection mechanisms for these lesions, particularly during the early stages, is essential to prevent their progression.

Methods: We examined histology reports of polyp lesions discovered during colonoscopies that employed CADe versus colonoscopies that did not utilize CADe. We calculated the number of SSA divided by the total number of colonoscopies. Furthermore, we calculated the Sessile Serrated Adenomas/polyps (SSA/Ps) ratio based on the total number of SSA divided by the total number of detected polyps. We divided the polyps based on CADe or Non-CADe and calculated mean size and age using T-test, assuming significance when p< 0.05.

Results: A total of 720 polyps were analyzed, of which 46.4% (n=334) were detected with CADe. We found that the use of CADe showed an increase in the detection of SSA per colonoscopy compared to the other studied arm (28.6% vs. 13.7%, p< 0.0001). Similarly, CADe detected significantly more SSA/Ps when compared to its counterpart; for SSA/Ps was 24.3% and 14.5%, respectively (p=0.0008). To further understand this effect, the mean polyp size for SSA lesions was analyzed and found that non-CADe procedures had an increased mean size (5.3mm) when compared to SSA obtained with CADe (3.9mm) (p=0.005). Interestingly, patients with SSA detected with CADe had a significantly lower mean age of 53.5 years when compared to 58.6 years in patients that presented SSA without CADe.

Discussion: Our findings suggest that CADe has a pivotal role in detecting SSA when we consider that CADe increases SSA detection rates. Since CADe increased the SSA/Ps ratio at the expense of having a mean smaller size and younger patient age, we can assume that the importance of CADe is more significant in early detection. Since CRC has become an important cause of morbidity and mortality, any effort that promotes early detection of potentially malignant lesions can help the efforts to reduce cancer rates. It is essential that further studies expand on the role of CADe in the early detection of CRC and efforts are made to upscale this technology.


Disclosures:


Cynthia Contreras, MD¹, Cesar Ortiz, MD², Paola Peña, MD², Ana Finke, MD², Sarah Herrera, MD², Maria Alonso, MD³, Nicole Peña, MD², Fernando Contreras, MD². P0337 - The Impact of CADe on Sessile Serrated Adenomas Detection Rate During Colonoscopy, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.