Type of study: Randomized controlled study

Investigated Procedure: Artificial Intelligence Software for Polyp Detection in Colonoscopy training

Trial participants: Endoscopy trainees during their training with at least one year of training ahead and no previous structured exposure to CADe

Objectives:

Primary: Adenoma Miss Rate (AMR) in the end of the first year of training for each group and after the crossover.

Secondary: Further endoscopists-related parameters will be recorded and compared between the two arms: PDR, ADR, aADR, PMR, withdrawal time, CIR, AEs

The investigators will be asked, when possible, to follow-up the patients until they have their next colonoscopy or a diagnosis of CRC to assess for interval cancer.

Inclusion Criteria:

• Trial participants: Endoscopy trainees at any time of their training, with at least one year of training ahead without previous structured exposure to CADe during their training.

Recruited patient population: Adult patients undergoing diagnostic, screening, or surveillance colonoscopy will be included.

1. Provision of signed and dated informed consent form understand the risks and benefits of the study
2. Aged ≥18 years old
3. Able to read and write in the provided language.
4. Participants capable to provide written informed consent and comply with the trial protocol.

Exclusion Criteria:

• Trial participants: Endoscopy trainees after their basic training, during the last year of training or with systematic exposure to CADe.

Recruited patient population:

1. Patients with a known contraindication for biopsy, bowel obstruction or perforation,
2. Pregnant or lactating females
3. Known polyposis syndromes, or who had a history of inflammatory bowel disease (IBD), CRC, or colorectal surgery.
4. Any patient whose cecum is not reached and who were highly suspected of having polyposis syndromes, IBD, intestinal tuberculosis, or CRC.
5. Incomplete bowel preparation (segmental Boston Bowel Preparation Score <2, or total <6)