{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T18:21:02Z","timestamp":1790619662741,"version":"4.1.0"},"reference-count":18,"publisher":"Georg Thieme Verlag KG","issue":"03","license":[{"start":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T00:00:00Z","timestamp":1759795200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000780","name":"European Commission","doi-asserted-by":"crossref","award":["101057099"],"award-info":[{"award-number":["101057099"]}],"id":[{"id":"10.13039\/501100000780","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100001691","name":"Japan Society of Promotion of Science","doi-asserted-by":"crossref","award":["22H03357"],"award-info":[{"award-number":["22H03357"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"crossref"}]},{"name":"National Institute for Health Research (NIHR) Oxford Biomedical Research Centre"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endoscopy"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>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.<\/jats:p>\n                  <jats:p>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 \u22645 mm predicted as non-neoplastic were not removed) with and without CADx assistance.<\/jats:p>\n                  <jats:p>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.<\/jats:p>\n                  <jats:p>Using CADx under a leave-in-situ strategy increased the environmental burden of colonoscopy.<\/jats:p>","DOI":"10.1055\/a-2717-8365","type":"journal-article","created":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T23:06:39Z","timestamp":1759878399000},"page":"303-309","source":"Crossref","is-referenced-by-count":3,"title":["Environmental impact of computer-aided diagnosis in colonoscopy: a carbon footprint assessment of a prospective study cohort"],"prefix":"10.1055","volume":"58","clinical-trial-number":[{"clinical-trial-number":"umin000027360","registry":"10.18810\/umin-japan"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4096-5862","authenticated-orcid":false,"given":"Olaolu","family":"Olabintan","sequence":"first","affiliation":[{"name":"King's Institute of Theraputic Endoscopy, King\u2019s College Hospital NHS Foundation Trust, London, United Kingdom of Great Britain and Northern Ireland"},{"name":"Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom of Great Britain and Northern Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalie","family":"Halvorsen","sequence":"first","affiliation":[{"name":"Clinical Effectiveness Research Group, University of Oslo, Oslo, Norway"},{"name":"Clinical Effectiveness Research Group, Oslo University Hospital, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robin","family":"Baddeley","sequence":"additional","affiliation":[{"name":"Wolfson Unit for Endoscopy, St Mark's Hospital and Academic Institute, London, United Kingdom of Great Britain and Northern Ireland"},{"name":"King\u2019s Institute of Therapeutic Endoscopy, King\u2019s College Hospital NHS Foundation Trust, London, United Kingdom of Great Britain and Northern Ireland"},{"name":"Faculty of Natural Sciences, Imperial College London, London, United Kingdom of Great Britain and Northern Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shin-ei","family":"Kudo","sequence":"additional","affiliation":[{"name":"Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, 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E.","family":"East","sequence":"additional","affiliation":[{"name":"Translational Gastroenterology Unit, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom of Great Britain and Northern Ireland"},{"name":"Division of Gastroenterology and Hepatology, Mayo Clinic Healthcare, London, United Kingdom of Great Britain and Northern Ireland"},{"name":"Oxford NIHR Biomedical Research Centre, Oxford, United Kingdom of Great Britain and Northern Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amit","family":"Rastogi","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, University of Kansas Medical Center, Kansas City, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-9084-6504","authenticated-orcid":false,"given":"Cesare","family":"Hassan","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy"},{"name":"Endoscopy Unit, IRCCS Humanitas Clinical and Research Center, Rozzano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mette","family":"Kalager","sequence":"additional","affiliation":[{"name":"Clinical Effectiveness Research Group, University of Oslo, Oslo, Norway"},{"name":"Clinical Effectiveness Research Group, Oslo University Hospital, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magnus","family":"L\u00f8berg","sequence":"additional","affiliation":[{"name":"Clinical Effectiveness Research Group, University of Oslo, Oslo, Norway"},{"name":"Clinical Effectiveness Research Group, Oslo University Hospital, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amyn","family":"Haji","sequence":"additional","affiliation":[{"name":"King's Institute of Therapeutic Endoscopy, King\u2019s College Hospital NHS Foundation Trust, London, United Kingdom of Great Britain and Northern 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