A recent Canadian study demonstrates the cost-effectiveness of AI-aided colonoscopy
It goes without saying that no one looks forward to a colonoscopy. The good news is that Canadian patients can benefit from a colorectal cancer screening tool that democratizes access to the best diagnostic care thanks to artificial intelligence. Canadian researchers have shown that adding artificial intelligence (AI)-aided computer assisted adenoma detection (CADe) to a colonoscopy program not only increases a patient's quality of life through advanced detection but doing so can be cost-effective within the Canadian health system. [i] Where previous studies have demonstrated the effectiveness of AI in colorectal adenoma detection rates, [ii] this recent study determined that detecting and treating more lesions in advance can help lower healthcare costs before lesions become more problematic.
AI-aided CADe system for colonoscopy, such as GI GeniusTM from Medtronic, uses enhanced visualization, analyzing imagery in real-time to help identify polyps, particularly subtle adenomas. Think of it as a second pair of tireless eyes supporting a specialist who may look at hours of colonoscopy footage in a day.
The study, Cost-effectiveness of Artificial Intelligence-Aided Colonoscopy for Adenoma Detection in Colon Cancer Screening,* is based on a standardized model in a Canadian healthcare setting using positive fecal immunochemical test (FIT) patients. Researchers posited that increasing advanced adenoma detection with CADe technology would make it more feasible to use the technology compared to the risk and added cost of treating colorectal cancer downstream. Their results established a per-procedure savings of $14 ($3,005 versus $2,991, factoring in a cost of $27 for AI-aided colonoscopy).
Earlier detection with AI-aided CADe can increase patient quality-adjusted life years, help attenuate staff burnout, provide population health insights, and increase health equity by standardizing care. Add in feasibility results from this recent study, and the technology qualifies for a healthcare improvement framework known as the quintuple aim.[iii]
"From a provincial payer's perspective, using CADe in a colonoscopy program is feasible. From a 'patient's point of view, they should be demanding this as a significant diagnostic advantage. At the end of the day, everybody can benefit," says Hamid Sadri, one of the study's authors and head of health economics at Medtronic Canada.
Colorectal cancer is the second leading cause of cancer death and the third most diagnosed cancer in Canada.[iv] Though rates of colorectal cancer were in decline between 2007 and 2018, likely due to increased screening, the pandemic backlog has led to a higher rate of advanced cases that could have been more manageable if discovered earlier.[v]
While raising awareness of colon cancer screening is one of the most effective means of addressing colon cancer, the proliferation of AI-aided CADe can be a powerful contributor to increased health equity.
Reprinted courtesy of Hospital News.
[i] Barkun, A. N., von Renteln, D., Sadri, H., (2023). Cost-effectiveness of Artificial Intelligence-Aided Colonoscopy for Adenoma Detection in Colon Cancer Screening. Journal of the Canadian Association of Gastroenterology, XX, 1–9. https://doi.org/10.1093/jcag/gwad014
[ii] Karsenti, D., et al. (2023). Effect of real-time computer-aided detection of colorectal adenoma in routine colonoscopy (COLO-GENIUS): A single-centre randomized controlled trial. Lancet Gastroenterology & Hepatology. Advance online publication. doi:10.1016/S2468-1253(23)00104-8. https://www.healio.com/news/gastroenterology/20230628/computeraided-detection-in-routine-colonoscopy-improves-adr-by-41
[iii] Coleman, K., Wagner, E., Schaefer, J., Reid, R., & LeRoy, L. (2016). Redefining Primary Care for the 21st Century. White Paper. (Prepared by Abt Associates, in partnership with the MacColl Center for Health Care Innovation and Bailit Health Purchasing, Cambridge, MA under Contract No. 290-2010-00004-I/290-32009-T.) AHRQ Publication No. 16(17)-0022-EF. Agency for Healthcare Research and Quality.
[v] Walker, M. J., Meggatto, O., Gao, J., Espino-Hernandez, G., Jembere, N., et al. (2021). Measuring the impact of the COVID-19 pandemic on organized cancer screening and diagnostic follow-up care in Ontario, Canada: A provincial, population-based study. Preventive Medicine. Advance online publication. DOI: https://doi.org/10.1016/j.ypmed.2021.106586.