Advances in artificial intelligence-based colonoscopic tools and modalities: Transforming colorectal cancer detection and management

Table 1 Summary of systematic reviews and meta-analyses evaluating the impact of artificial intelligence-assisted colonoscopy on adenoma detection rate

Ref.	Study type	Number of studies/participants	Main outcomes	Key findings
Khalaf et al[10], 2025	Systematic review and meta-analysis	7 RCTs/5427 participants	ADR, PDR	AI-assisted colonoscopy significantly increased ADR and PDR. Most additional lesions detected were small polyps, while detection of advanced adenomas and pedunculated lesions was lower
Huang et al[15], 2022	Meta-analysis	10 RCTs/6629 participants	ADR, PDR, lesions per colonoscopy	AI significantly improved ADR and PDR. Higher numbers of adenomas, polyps, and sessile serrated lesions were detected per colonoscopy, with benefits across most lesion sizes and locations except pedunculated lesions and cecal lesions
Makar et al[11], 2025	Updated meta-analysis	28 RCTs/23861 participants	ADR, adenoma miss rate	CADe increased ADR by approximately 20% and reduced adenoma miss rates by 55%. Benefits were consistent across platforms, endoscopist experience levels, and clinical settings
Hassan et al[16], 2021	Meta-analysis	5 RCTs/4354 participants	ADR	CADe consistently demonstrated benefit (36.6% vs 25.2%) compared with conventional colonoscopy, with improvements across different lesion sizes, morphologies, and anatomical locations
Hassan et al[12], 2023	Systematic review and meta-analysis	21 RCTs/18232 participants	ADR, adenoma miss rate	CADe-assisted colonoscopy significantly increased ADR (44.0% vs 35.9%) and reduced adenoma miss rates compared with standard colonoscopy
Soleymanjahi et al[13], 2024	Systematic review and meta-analysis	44 RCTs/36201 participants	ADR, adenomas per colonoscopy	CADe was associated with increased detection and increased the average number of adenomas detected per colonoscopy
Adiwinata et al[17], 2023	Systematic review and meta-analysis	Multiple studies	ADR	AI-assisted colonoscopy significantly improved ADR with a pooled odds ratio of 1.58, confirming a clear detection advantage over conventional colonoscopy

AI: Artificial intelligence; ADR: Adenoma detection rate; PDR: Polyp detection rate; RCTs: Randomised controlled trials; CADe: Computer-aided detection.