P1773 - Comparing Sessile Serrated Adenoma/Polyp Detection Rate Between Water Exchange and Computer-Aided Detection Colonoscopy Using Pooled Data From Randomized Controlled Trials

Paul P. Shao, MD¹, Jonathan Kuo, MS², Changhan R. Shao, MBBS³, Felix W. Leung, MD, FACG^4
1Stanford University, Redwood City, CA; ²Touro University Nevada, Henderson, NV; ³Linkou Chang Gung Memorial Hospital, Taoyuan City, Taoyuan, Taiwan; ⁴Sepulveda ACC/VAGLAHS/UCLA, North Hills, CA

Introduction: Sessile serrated adenomas/polyps (SSA/Ps) contribute to 20-30% of proximal colorectal cancers. SSA/Ps are flat with indistinct border and have a pale color that is similar to the normal mucosa. They are often covered by mucous and are easy to miss on colonoscopy. Therefore, SSA/Ps are implicated in the development of interval cancers. Early detection and removal of SSA/Ps may decrease risk of interval cancers. Both water exchange (WE) and computer-aided colonoscopy (CADe) have been shown to improve adenoma detection. This study aimed to compare the SSA/P detection rate (SSA/PDR) of WE and CADe.

Methods: Literature databases were searched and reviewed systemically using keywords, water exchange, artificial intelligence, computer-aided detection, colonoscopy, and adenoma detection. Randomized controlled trials (RCTs) on either WE or CADe comparing with conventional colonoscopy that reported SSA/PDR were included in the study. Data from included RCTs were extracted and pooled together. SSA/PDR of WE and CADe were compared against their respective control cohorts and each other using the chi-square test.

Results: 14 RCTs comparing WE or CADe with conventional colonoscopy were identified from the literature search and included in our study. A total of 4380 patients underwent WE or conventional colonoscopy in 4 RCTs. WE significantly improved SSA/PDR compared with conventional colonoscopy (5.8% vs 3.4%, p< 0.001). In another 10 RCTs, 9355 patients underwent CADe or conventional colonoscopy. SSAP/DR of CADe was not significantly different from that of conventional colonoscopy (4.5% vs. 4.9%, p=0.27). SSA/PDR of WE was significantly higher than CADe (5.8% vs. 4.5%, p=0.029).

Discussion: WE significantly improved detection of SSA/P whereas CADe did not significantly impact SSA/P detection compared with conventional colonoscopy. WE was superior to CADe in detection of SSA/P.


Disclosures:


Paul P. Shao, MD¹, Jonathan Kuo, MS², Changhan R. Shao, MBBS³, Felix W. Leung, MD, FACG⁴. P1773 - Comparing Sessile Serrated Adenoma/Polyp Detection Rate Between Water Exchange and Computer-Aided Detection Colonoscopy Using Pooled Data From Randomized Controlled Trials, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.