gence, the exciting next step in colonoscopy screenings. The technol-
ogy is based on machine learning and has the potential to significantly
improve adenoma detection rates.
Artificial intelligence platforms are "taught" to identify high-risk
areas of the colon wall by "learning" from tens of thousands of images
of both normal and abnormal mucosal tissue. As an endoscopist with-
draws the colonoscope, the artificial intelligence platform that's inte-
grated into the scope assess the colon's walls and places a virtual box
around areas where polyps are likely to be, alerting the endoscopist to
take a closer look.
This application is just the beginning of capitalizing on the benefits
of artificial intelligence in gastroenterology. The technology's use will
likely expand to helping physicians identify areas of precancerous
change during upper GI procedures and dysplasia in patients with
Barrett's esophagus. It will also assist in screening patients with
inflammatory bowel disease — chronic ulcerative colitis and Chron's
disease, for example — who are at increased risk of developing pre-
cancerous and cancerous lesions in the colon.
Increased demand for colonoscopy
The American Cancer Society's updated guideline for colorectal
cancer screening responded to increasing rates of colon cancer in
younger adults by recommending average-risk individuals begin
screening at age 45 instead of age 50. It's difficult to predict how many
more screenings your facility will do as a result, but my sense is that it
won't be necessary to invest in additional equipment, manpower and
scope inventory to match the demand — at least not yet. It's best to
hold off making significant changes to your practice until we see if
insurance carriers fully cover screenings for younger patients and
how much case volumes actually increase.
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