P0516 - Power of Artificial Intelligence in Addressing Disparities and Enhancing Colorectal Cancer Screening: A Narrative Review

Shivam Kalra, MBBS, MHA¹, Aaryan Sharma, ², Rajiv Sharma, MD³
1Trident Medical Center, North Charleston, SC; 2IMG Academy, Bradenton, FL; 3Banner Medical Group, Phoenix, AZ

Introduction: Colorectal cancer (CRC) is 3rd most common cancer and a is a leading cause of deaths in the US. Colonoscopy, is by far, the most ideal test in reducing CRC incidence and mortality. Despite its effectiveness and spending 3.2 billion $/year in outpatient colonoscopies, disparities in screening uptake and follow-up care persist among racial and ethnic minorities. AI in Adenoma Detection has already known to have made a mark in enhancing colonoscopy effectiveness and decreasing pathologies testing costs. We will discuss role of AI in bridging the gaps in CRC screening.

Methods: PubMed was searched for available data and latest guidelines. Costs associated with Colonoscopy, Cologuard and FIT test was determined. CRC screening rates via all modalities available in various minority groups were noted. CRC incidence rate in all minorities were noted through available metanalysis. Role of AI is determined in order to enhance the CRC screening rates and thereby promoting health equity.

Results: Screening rates are generally lower among Black, Hispanic, and Asian populations compared to White populations, though some recent data suggest improvements in certain settings. Mortality rates remain highest among Black and American Indian/Alaska Native (AI/AN) populations, with socioeconomic status and access to care being major contributors to these disparities.

Table 1: Comparative 10-Year Cost and Effectiveness of CRC Screening Modalities

Screening Strategy	Cost (USD)	QALY Gain	Notes
FIT (Annual)	$250	0.92	Most cost-effective (screening only)
Colonoscopy (Every 10y)	$2,000	0.93	Diagnostic + therapeutic
mt-sDNA (Every 3y)	$1,650	0.91	Higher cost, similar effectiveness

Table 2: CRC Screening and Mortality Amongst Various Minorities.

Race/Ethnicity CRC Screening Rate (%) CRC Mortality Rate (per 100,000) Non-Hispanic White 70 13.1–13.6 Non-Hispanic Black 67 17.2–18.0 Hispanic/Latino 49 19.7–21.9 Asian/Pacific Islander 61 9.1–9.4 American Indian/Alaska Native 51 15.1–17.6

Discussion: “Your zip code is more important than your DNA”. The ACP, ACG and USPSTF all emphasize the need for targeted interventions to improve screening and outcomes in high-risk groups. AI along with geographical population subsets, can detect the trends in the community and hence, extrapolating the minority and underrepresented populations, can help in equitable screening. AI can thereby bridge the gap and enhance health equity. AI can help us save 5 billion $ in healthcare expenses from CRC prevention in minority groups.


Figure: Proposed Algorithm

Disclosures:
Shivam Kalra indicated no relevant financial relationships.
Aaryan Sharma indicated no relevant financial relationships.
Rajiv Sharma indicated no relevant financial relationships.

Shivam Kalra, MBBS, MHA¹, Aaryan Sharma, ², Rajiv Sharma, MD³. P0516 - Power of Artificial Intelligence in Addressing Disparities and Enhancing Colorectal Cancer Screening: A Narrative Review, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.