This trial will be conducted in five centers (Table 1) across Canada. All patients who meet the in/exclusion criteria can be enrolled. The patient's personal medical history will be reviewed to verify patient inclusion and exclusion criteria (age, history of CRC or adenoma, comorbid conditions, anticoagulation, etc.).~Eligible patients will be randomized (1:1) stratified per center in two arms:~Intervention arm: patients will be assigned to undergo colonoscopy in a room equipped with the GI genius CAD system.~Control arm: patients will undergo colonoscopy in a room not equipped with the GI genius CADe system.~Allocation will be concealed and study participation not know to the endoscopist performing the procedure. This study will be a pragmatic double-blinded: the patients and the endoscopist will be blinded to the allocated group.~Data will be collected on case report forms (CRF), after the procedure, from the clinical files and the endoscopy reports. The data will then be deidentified and transferred to an electronic RedCap database in each institution. A research assistant will collect all information and annotations recorded on the patient's medical file during the procedure.~In the treatment group (GI genius CADe assisted colonoscopy), the Medtronic-GI genius system provides real-time support to endoscopists to detect polyps of any range of sizes. CADe will provide real-time feedback throughout each colonoscopy procedure and will alert the endoscopists of the presence of a polyp in the endoscopy field by displaying a bounding box on the same screen.~In the control group (standard colonoscopy), the participating endoscopists will detect and classify colorectal lesions without using any AI modules. The classification of the polyps will also be based on the NICE and SANO classification systems as performed in the treatment group.~After detecting a polyp and performing optical diagnosis for all 1-10 mm polyps, the endoscopists will remove all polyps using standard technique\s. 1-2 mm polyps can be removed using a standard biopsy forceps or polypectomy snares, and polyps 3-10 mm with a standard polypectomy snare (preferably cold snares for all small polypus), 10-20 mm polyps are removed using a polypectomy snare (cold or hot upon endoscopist's decision), and >20 mm polyps using EMR or ESD.~All polyps will be resected and sent to the pathology labs of the participating institutions to be evaluated for histology by board-certified pathologists. The histopathology outcomes will be collected and stored in the CRF forms to be used as a reference later.
This is a pragmatic, double-blind, randomized, controlled trial, to assess whether the implementation of CADe (GI genius) significantly affects the ADR in screening and surveillance population.~The hypothesis is that implementing the GI genius CADe system will result in a significantly higher ADR in the treatment group compared to the control group (conventional colonoscopy).