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From November 2021 to November 2022, 933 individuals undergoing colorectal cancer screening or post-polypectomy surveillance were recruited and randomized in five outpatient treating centers (10 examiners; &gt;10 years of experience). 914 Patients were included in the intention to treat analysis (CAC:452, TC:462) and detected lesions were framed on the primary monitor in the CAC group. More than 94% of the examinations were screening or surveillance colonoscopies with overall similar patient characteristics. The ADR (CAC:34.5% vs TC:32.9%;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.656) was not significantly different between the groups. The effect of CAC on ADR remains a controversial discussion. Diverging study setups and patient collectives complicate consistent comparisons. Future studies should focus on large-scale real-world populations. 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