计算机辅助检测在鉴定晚期结直肠新生物中的作用尚不明确。为评估计算机辅助检测对结肠镜鉴定晚期结直肠新生物以及腺瘤、锯齿状息肉、无息肉性和右侧病变的贡献，进行了多中心、平行、随机对照试验（ClinicalTrials.gov: NCT04673136）。该试验纳入了西班牙结直肠癌筛查计划中的3213名粪便免疫化学试验阳性者，随机分配到带有或不带有计算机辅助检测的结肠镜检查组。晚期结直肠新生物定义为晚期腺瘤和/或晚期锯齿状息肉。两个对照组在晚期结直肠新生物检出率（干预组为34.8%，对照组为34.6%；校正风险比[aRR]，1.01 [95% CI，0.92-1.10]）以及每次结肠镜检查检出的晚期结直肠新生物的均值（干预组为0.54 [SD，0.95]，对照组为0.52 [SD，0.95]；校正率比，1.04 [99.9% CI，0.88-1.22]）上没有显著差异。腺瘤检出率也没有差异（干预组为64.2%，对照组为62.0%；aRR，1.06 [99.9% CI，0.91-1.23]）。计算机辅助检测增加了无息肉性病变的均值（干预组为0.56 [SD，1.25]，对照组为0.47 [SD，1.18]；校正率比，1.19 [99.9% CI，1.01-1.41]）、近端腺瘤的均值（干预组为0.94 [SD，1.62]，对照组为0.81 [SD，1.52]；校正率比，1.17 [99.9% CI，1.03-1.33]）以及每次结肠镜检查中检出的5毫米或更小的病变（总体息肉及腺瘤和锯齿状病变）的数量。对照组中高的腺瘤检出率可能限制了研究结果在腔镜医生腺瘤检出率低的一般性。计算机辅助检测并没有改善结肠镜对晚期结直肠新生物的鉴定能力。Medtronic.

The role of computer-aided detection in identifying advanced colorectal neoplasia is unknown.To evaluate the contribution of computer-aided detection to colonoscopic detection of advanced colorectal neoplasias as well as adenomas, serrated polyps, and nonpolypoid and right-sided lesions.Multicenter, parallel, randomized controlled trial. (ClinicalTrials.gov: NCT04673136).Spanish colorectal cancer screening program.3213 persons with a positive fecal immunochemical test.Enrollees were randomly assigned to colonoscopy with or without computer-aided detection.Advanced colorectal neoplasia was defined as advanced adenoma and/or advanced serrated polyp.The 2 comparison groups showed no significant difference in advanced colorectal neoplasia detection rate (34.8% with intervention vs. 34.6% for controls; adjusted risk ratio [aRR], 1.01 [95% CI, 0.92 to 1.10]) or the mean number of advanced colorectal neoplasias detected per colonoscopy (0.54 [SD, 0.95] with intervention vs. 0.52 [SD, 0.95] for controls; adjusted rate ratio, 1.04 [99.9% CI, 0.88 to 1.22]). Adenoma detection rate also did not differ (64.2% with intervention vs. 62.0% for controls; aRR, 1.06 [99.9% CI, 0.91 to 1.23]). Computer-aided detection increased the mean number of nonpolypoid lesions (0.56 [SD, 1.25] vs. 0.47 [SD, 1.18] for controls; adjusted rate ratio, 1.19 [99.9% CI, 1.01 to 1.41]), proximal adenomas (0.94 [SD, 1.62] vs. 0.81 [SD, 1.52] for controls; adjusted rate ratio, 1.17 [99.9% CI, 1.03 to 1.33]), and lesions of 5 mm or smaller (polyps in general and adenomas and serrated lesions in particular) detected per colonoscopy.The high adenoma detection rate in the control group may limit the generalizability of the findings to endoscopists with low detection rates.Computer-aided detection did not improve colonoscopic identification of advanced colorectal neoplasias.Medtronic.