Environmental impact of computer-aided diagnosis in colonoscopy: a carbon footprint assessment of a prospective study cohort
The environmental impact of computer-aided diagnosis (CADx) in colonoscopy is unknown. The potential to reduce greenhouse gas emissions by limiting unnecessary polypectomies may be offset by emissions associated with CADx devices. We quantified and compared the carbon footprint of colonoscopy with and without CADx.Life-cycle carbon emissions associated with endoscopic snares, polyp traps, histopathology, and CADx devices were estimated using life-cycle assessment software. The effect of CADx was estimated by the carbon dioxide equivalent (CO2e) emissions related to outcomes from a prospective cohort of patients who underwent colonoscopy with optical diagnosis under a leave-in-situ strategy (i.e. rectosigmoid polyps ≤5 mm predicted as non-neoplastic were not removed) with and without CADx assistance.We analyzed 1134 individuals (median age 67 years, 59% male) with 1716 colorectal polyps. Colonoscopy with CADx reduced the number of snares and polyp traps from 567 to 543 (difference: 24) and histopathology submissions from 1343 to 1278 (difference: 65). However, the total carbon footprint increased from 832 kg CO2e (95%CI 815 to 847) without CADx to 946 kg CO2e (95%CI 927 to 965) with CADx, corresponding to an absolute increase of 114 kg CO2e (95%CI 80 to 150) or 0.10 kg CO2e per colonoscopy.Using CADx under a leave-in-situ strategy increased the environmental burden of colonoscopy.
Authors
- Amyn Haji (ORCID: https://orcid.org/0000-0003-0866-981X)
- Ishita Barua (ORCID: https://orcid.org/0000-0003-4200-8521)
- Jens Aksel Nilsen (ORCID: https://orcid.org/0000-0002-7792-0249)
- Magnus Løberg (ORCID: https://orcid.org/0000-0003-2231-1304)
- Øyvind Holme (ORCID: https://orcid.org/0000-0001-6290-4812)
- Kensaku Mori (ORCID: https://orcid.org/0000-0002-0100-4797)
- Natalie Halvorsen (ORCID: https://orcid.org/0009-0009-3062-036X)
- Olaolu Olabintan (ORCID: https://orcid.org/0000-0003-4096-5862)
- Michael Bretthauer (ORCID: https://orcid.org/0000-0001-9653-6886)
- Masashi Misawa (ORCID: https://orcid.org/0000-0002-8520-2036)
- Robin Baddeley (ORCID: https://orcid.org/0000-0001-5604-246X)
- Svein Oskar Frigstad (ORCID: https://orcid.org/0000-0001-7841-608X)
- Claire Hunt (ORCID: https://orcid.org/0000-0002-8142-2314)
- Mette Kalager (ORCID: https://orcid.org/0000-0003-2504-108X)
- Bu Hayee (ORCID: https://orcid.org/0000-0003-1670-8815)
- Toyoki Kudo (ORCID: https://orcid.org/0000-0002-2953-9603)
- James E. East (ORCID: https://orcid.org/0000-0001-8035-3700)
- Yuichi Mori (ORCID: https://orcid.org/0000-0003-2262-0334)
- Shraddha Gulati (ORCID: https://orcid.org/0000-0002-1394-011X)
- Amit Rastogi
- Cesare Hassan (ORCID: https://orcid.org/0009-0009-9084-6504)
Institutions
- Oslo University Hospital (NO)
- Humanitas University (IT)
- King's College London (GB)
- University of Oslo (NO)
- Veterans Health Administration (US)
- Vestre Viken Hospital Trust (NO)
- American Society for Gastrointestinal Endoscopy (US)
- John Radcliffe Hospital (GB)
- SHOWA Medical University Northern Yokohama Hospital (JP)
- King's College Hospital NHS Foundation Trust (GB)
- Mayo Clinic in Arizona (US)
- University of Kansas Medical Center (US)
- Oxford BioMedica (United Kingdom) (GB)
- Istituti di Ricovero e Cura a Carattere Scientifico (IT)
- King's College Hospital (GB)
- St Mark's Hospital (GB)
- Sørlandet Sykehus (NO)
- Imperial College London (GB)
- Nagoya University (JP)
Publication Details
- Journal
- Endoscopy
- Published
- 2025-10-07
- DOI
- https://doi.org/10.1055/a-2717-8365
- Primary Topic
- Air Quality Monitoring and Forecasting
- Type
- article
- Field-Weighted Citation Impact
- 0.00