Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2025 Oct;10(10):896-903.
doi: 10.1016/S2468-1253(25)00133-5. Epub 2025 Aug 12.

Endoscopist deskilling risk after exposure to artificial intelligence in colonoscopy: a multicentre, observational study

Krzysztof Budzyń  1 , Marcin Romańczyk  2 , Diana Kitala  3 , Paweł Kołodziej  4 , Marek Bugajski  5 , Hans O Adami  6 , Johannes Blom  7 , Marek Buszkiewicz  8 , Natalie Halvorsen  9 , Cesare Hassan  10 , Tomasz Romańczyk  1 , Øyvind Holme  11 , Krzysztof Jarus  12 , Shona Fielding  13 , Melina Kunar  14 , Maria Pellise  15 , Nastazja Pilonis  16 , Michał Filip Kamiński  17 , Mette Kalager  9 , Michael Bretthauer  9 , Yuichi Mori  18
Affiliations
Observational Study

Endoscopist deskilling risk after exposure to artificial intelligence in colonoscopy: a multicentre, observational study

Krzysztof Budzyń et al. Lancet Gastroenterol Hepatol. 2025 Oct.

Erratum in

Abstract

Background: It is not known if continuous exposure to artificial intelligence (AI) changes endoscopists' behaviour when conducting colonoscopy. We assessed how endoscopists who regularly used AI performed colonoscopy when AI was not in use.

Methods: We conducted a retrospective, observational study at four endoscopy centres in Poland taking part in the ACCEPT (Artificial Intelligence in Colonoscopy for Cancer Prevention) trial. These centres introduced AI tools for polyp detection at the end of 2021, after which colonoscopies had been randomly assigned to be conducted with or without AI assistance according to the date of examination. We evaluated the quality of colonoscopy by comparing two different phases: 3 months before and 3 months after AI implementation. We included all diagnostic colonoscopies, excluding those involving intensive anticoagulant use, pregnancy, or a history of colorectal resection or inflammatory bowel disease. The primary outcome was change in adenoma detection rate (ADR) of standard, non-AI assisted colonoscopy before and after AI exposure. Multivariable logistic regression was done to identify independent factors affecting ADR.

Findings: Between Sept 8, 2021, and March 9, 2022, 1443 patients underwent non-AI assisted colonoscopy before (n=795) and after (n=648) the introduction of AI (median age 61 years [IQR 45-70], 847 [58·7%] female, 596 [41·3%] male). The ADR of standard colonoscopy decreased significantly from 28·4% (226 of 795) before to 22·4% (145 of 648) after exposure to AI, corresponding with an absolute difference of -6·0% (95% CI -10·5 to -1·6; p=0·0089). In multivariable logistic regression analysis, exposure to AI (odds ratio 0·69 [95% CI 0·53-0·89]), male versus female patient sex (1·78 [1·38-2·30]), and patient age ≥60 years versus <60 years (3·60 [2·74-4·72]) were the independent factors significantly associated with ADR.

Interpretation: Continuous exposure to AI might reduce the ADR of standard non-AI assisted colonoscopy, suggesting a negative effect on endoscopist behaviour.

Funding: European Commission and Japan Society for the Promotion of Science.

PubMed Disclaimer

Conflict of interest statement

Declaration of interests YM has received consultancy fees, speaker's fees, and a device loan from Olympus, royalty fees from Cybernet System, and financial support from the European Commission (Horizon Europe 101057099) and the Japan Society for the Promotion of Science (22H03357). MP has received consultancy fees from Olympus Europe and Alfasigma, speaker's fees from Olympus, Casen Recordati, and Mayoly, and travel fees from Mayoly. CH has received a consultancy fee and device loan from Odin, device loan and speaker's fees from Olympus, and financial support from the European Commission (Horizon Europe 101057099), The Associazione Italiana per la Ricerca sul Cancro (IG 2022–ID. 27843 project, IG 2023–ID. 29220 project, and Bando PNRR-MCNT2–2023–12377041). SF's institution has received funds from Oslo University Hospital to cover statistical consultancy activities. MFK has received consultancy fees from Olympus, Boston Scientific, and Erbe, and speaking and teaching fees from Olympus Corp, Fujifilm, Boston Scientific, Medtronic, Erbe, Microtech, and Norgine. KB, MR, DK, PK, MBug, HOA, JB, MBus, NH, TR, ØH, KJ, MKu, NP, MKa, MBr- declare no competing interests.

Publication types

LinkOut - more resources