Recently, physicians from Penn Presbyterian Medical Center (PPMC)’s division of Gastroenterology and Hepatology launched a three-year pilot program to determine if artificial intelligence (AI) technology could improve precancerous polyp detection in screening colonoscopies.
Colorectal cancer is the third-most common cancer in the world and the second-most common cause of cancer deaths. It is also among the most preventable cancers with regular screening colonoscopies, but “even if you are adherent to a standard schedule of screening and surveillance colonoscopies for a lifetime, there is still a small but real five- to nine-percent risk of developing colon cancer because there may be small polyps in the colon that are missed,” said gastroenterologist Neilanjan Nandi, MD, FACP, who coordinates the new AI platform.
While the national benchmark for detection of precancerous polyps, known as the adenoma detection rate, or ADR, is about 26 percent, the rate across the entire University of Pennsylvania Health System (UPHS) is much higher at around 40 percent.
“However, we are always looking for other proactive methods to continue to improve and provide the highest level of quality care to our patients,” Nandi said.
That’s where the GI Genius, an FDA-approved system for screening and surveillance colonoscopy that works with standard endoscopy equipment, comes in. While the physician views real-time images of the colon, the system highlights any areas where it detects a suspected polyp. Clinical studies with this platform have revealed a roughly 13 percent increase in polyp detection using AI-assisted colonoscopy versus standard colonoscopy.
Medtronic, the manufacturer of GI Genius, partnered with the American Society for Gastrointestinal Endoscopy to offer the equipment to under-resourced communities, like those that PPMC serves. Right now, colorectal cancer has higher rates in the Black community than any other racial or ethnic group. Penn Medicine has been on a multi-year journey to both raise the rates of screening for colorectal cancer and increase uptake of follow up care, with the goal of driving down colorectal cancer death rates and addressing inequities.
Nandi collaborated with colleagues to apply for the grant and received three units to use for free for three years. PPMC is one of only a few sites employing this technology. If success is demonstrated here, then plans to further expand AI to other Penn sites may be considered.
Nandi pointed out that while AI is a valuable tool, it is not a substitute for the skill and judgment of a clinician.
“Our equipment is state-of-the-art, but our physicians are extremely well trained. That is the reason why our ADR rates far surpass the national average,” Nandi said. “Patients can be assured that anywhere they get a colonoscopy at Penn Medicine, they are in skilled hands and getting access to the very best of care.”