Watch out for flat polyps
Find out how artificial intelligence helps doctors to identify these hard-to-detect growths before they become cancerous.
Colorectal cancer, or cancer that starts in the colon (large intestine) or rectum, is the most common cancer in Singapore. Nearly all colorectal cancers begin as polyps, which are growths on the inner lining of the colon or rectum that may turn cancerous over time.
Polyps in the colon can be detected and removed during colonoscopy. Common polyps are those that protrude and look like a mushroom growing from the intestinal wall, which are easy to detect during a colonoscopy. However, there are 'flat' polyps that grow along the sides of the intestinal wall or are hidden from view behind a fold. If undetected, these flat polyps have the potential to become cancerous more quickly than regular polyps.
An Artificial Intelligence (AI)-assisted colonoscopy could increase the odds of finding polyps, especially the flat ones, which have been traditionally difficult for doctors to detect.
SKH has adopted the use of AI technology to complement the hospital's existing colonoscopy services since July 2021. Sharing how AI-aided colonoscopy works, Dr Frederick Koh, Consultant, Department of Surgery at SKH, says, "As with most AI technology, the system is fed with a large number of images of polyps to strengthen its pattern recognition system. As the colon walls are examined during a colonoscopy, the AI is able to identify sites of irregularities in real time and highlights areas that might be otherwise overlooked. The AI works like a second pair of eyes to help us doctors survey and identify polyps better."
Many factors increase the risk of polyps growing, including those that we can change like obesity, lack of exercise, smoking and excessive alcohol intake. Those that cannot be changed are age, being male, having a family history of colon cancer, personal history of colonic polyps, inflammatory conditions like Crohn's disease and Ulcerative Colitis, genetic or hereditary conditions like Familial Adenomatous Polyposis or Peutz-Jeghers syndrome. With colorectal cancer rising sharply in adults as young as 18 to 35, this real-time AI endoscopy is proving to be a useful tool for improving patients' colorectal outcomes.
Caption: An irregularity detected by the AI technology during a colonoscopy
Caption: Dr Frederick Koh with the real-time AI-aided endoscopy equipment
A recent one-year study by SKH revealed that AI-assisted colonoscopies yielded significantly higher rates of polyp removal (34%) compared with non-AI-assisted colonoscopies (28%) out of 2,433 AI-assisted colonoscopies and 1,770 non-AI-assisted colonoscopies performed. It is notable that 71% of all polyps removed were pre-cancerous in nature.
You can greatly reduce your risk of developing colorectal cancer by undergoing regular screenings as most colorectal cancers do not cause symptoms in the early stage.
Adopt healthy habits. Eat plenty of fruits and vegetables and reduce your fat intake. Limit alcohol consumption and quit smoking. Stay physically active and maintain healthy body weight.
Calcium and vitamin D. Studies have shown that increasing consumption of calcium and vitamin D may also help. While clinical trials suggest that calcium may reduce chances of developing polyps, few studies have examined whether calcium can protect against colon cancer.
Dr Koh recommends individuals who are well to go for colonoscopies from the age of 50, in accordance with national guidelines. After all, routine colonoscopy examinations with the removal of polyps can reduce the incidence of colorectal cancer by approximately 75%.
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