P0468Can AI-assisted 6-minute Colonoscopy Achieve a Qualified Adenoma Detection Rate? A single-center Randomized Controlled Trial in China

Background China’s current colonoscopy quality standards recommend a minimum withdrawal time (WT) of 6 minutes and an adenoma detection rate(ADR) of ≥ 15%. However, the AJG guidelines have raised the minimum withdrawal time standard to 8 minutes and increased the ADR to ≥ 35%. The guidelines also state that if the ADR is substandard and the withdrawal time is less than 8 minutes, the withdrawal time should be extended to 8 minutes. If the ADR is qualified, the withdrawal time is not mandatory to reach 8 minutes. If the time of withdrawal is prolonged, the efficiency of the examination will be reduced.In light of recent advancements in AI-assisted techniques that can improve adenoma detection rates, we consider whether a 6-minute withdrawal time with AI assistance could achieve the qualified ADR of 8 minutes, thereby enhancing examination efficiency and quality. Methods This study compared the impact of 8-minute vs AI-assisted 6-minute withdrawal time on adenoma detection rates, aiming to determine whether the 6-minute approach could achieve acceptable detection rates and whether maintaining the 8-minute withdrawal time remains necessary.This randomized controlled trial enrolled 207 patients at Wuxi People’s Hospital from June to October 2025. Participants were randomly assigned to two groups: the 8-minute withdrawal time and another with 6-minute withdrawal time assisted by AI, with withdrawal speed regulated by a timer. The primary endpoints were adenoma detection rate(ADR), advanced adenoma detection rate (AADR), and polyp detection rate (PDR). Results The baseline characteristics of the two patient groups were similar (Table 1). During colonoscopy, no significant differences were observed in bowel preparation quality, cecal intubation rate, cecal intubation time, cecal intubation distance, abdominal compression frequency, or position changes between the groups (Table 2). There was no significant difference in adenoma detection rates (8-minute WT group: 42.9% vs 6-minute+AI group: 38.2%, P=0.572). Although the 6-minute+AI group showed lower detection rates for advanced adenomas and polyps (5.7% vs 2.0%, P=0.298; 57.1% vs 43.1%, P=0.052) compared to the 8-minute WT group, these differences were not statistically significant. Further analysis revealed both groups were more likely to detect polyps in the left colon (splenic flexure, descending colon, sigmoid colon, rectum), with a higher proportion of polyps measuring ≤5mm in length (Table 3). Conclusion With AI assistance, the 6-minute endoscopic withdrawal time achieves a 35% adenoma detection rate, meeting guideline requirements and showing no significant difference from the 8-minute withdrawal time. Therefore, the 6-minute endoscopic withdrawal time is acceptable with AI assistance. Conflict of interest: Ms. Zhang, Haoyan: No conflict of interest Xu, Congzhou: No conflict of interest Yang, Cheng: No conflict of interest