Since March, doctors at University Hospitals' (UH) main campus near University Circle in Cleveland have been using artificial intelligence to detect polyps during colonoscopies.
This fall, the hospital system will receive four more units through a grant by the Medtronic Health Equity Assistance Program to provide colorectal screening in medically underserved communities.
During the procedure, a green box pops up on the monitor and highlights areas the AI software thinks might be a polyp, said Dr. Gerard Isenberg, chief medical quality officer for the UH Digestive Health Institute.
He said recent studies find physicians miss about 25% of precancerous polyps during colonoscopies.
“A 30 minute colonoscopy is about 54,000 frames of pictures," Isenberg said. "You can imagine that a person looking at 54,000 pictures, you get distracted. Your eye kind of glosses over things.”
He said the artificial intelligence program is like having a second set of eyes that almost never misses anything.
"This technology is one of the few things we have that can make a difference in reducing colon cancer," Isenberg said.
The modules, which were authorized by the Food and Drug Administration last year, resulted in a nearly 50% reduction in missed colorectal polys compared to a standard colonoscopy in the first U.S. trial, according to UH.
If left undetected and untreated polyps can lead to colorectal cancer. The new AI modules have a sensitivity rate per lesion of more than 99%, according to the hospital.
When caught early, certain types of colorectal cancer have a five-year survival rate of over 90%, but the cancer remains the third most common and the second deadliest in the country, according to UH.
Colorectal cancer is particularly deadly in Northeast Ohio where the mortality rate exceeds the national average. Diagnoses of the disease among Northeast Ohioans below age 50 are on the rise, according to UH.
“This statistic is worrisome and shows why we need to start screening at age 45 in people with no risk factors as now recommended by several national organizations and even earlier in those people with risk factors,” Isenberg said.
People can reach out to University Hospitals to set up an appointment for a colonoscopy without a doctor's referral. There are options available for people without medical insurance, according to UH.
Isenberg said the hospital system plans to educate communities about the new technology by holding screening events. Physicians will go to church groups and community centers where there are disparities in income and access to care, which impacts who gets colonoscopies done.
"It’s not just having this technology." he said. "It's trying to reach out to people about the dangers of colon cancer and why there’s such a disparity between whites and Blacks."
Black Americans have a lower rate of survival five years after diagnosis, he said.
Anyone over the age of 45 should get screened, according to Isenberg. People with inflammatory bowel diseases or who have a family member who has been diagnosed with colon cancer should be screened even earlier.
He said people shouldn't be afraid of discomfort during a colonoscopy.
"With the ability to give sedation nowadays, the new endoscopes that we have and just the fact that people are better trained than what they were maybe even 20 years ago, the procedure is actually very safe, and it's easy," Isenberg said.
The new units will be placed in each general endoscopy rooms on UH's main campus, according to the hospital. Another will be moved to UH's Ahuja Medical Center in Beachwood.
"By finding and removing a polyp, we can prevent a cancer from forming," Isenberg said. "This AI technology helps us to reduce the variability in finding these precancerous polyps and makes an impact on improving the health of our patients.”
