Among the speakers at Wired Health, the event organized last March 15 in Milan by Wired with the scientific and editorial collaboration of Humanitas and dedicated to health technologies, was Professor Alessandro Repici, Head of Digestive Endoscopy at Humanitas and Professor at Humanitas University with a speech entitled “New diagnostic techniques in Gastroenterology”.
Gastroenterology and Endoscopy
Professor Repici began by recalling what gastroenterology is about: “It is one of the most important disciplines in the medical field because it takes care of a huge district of our organism (the gastrointestinal one) with a unique involvement of organs in the panorama of medicine. Gastroenterology is also very transversal and has skills that meet different aspects of metabolism, obesity and diabetes. This branch ranges from infectious diseases (such as viral hepatitis) to functional diseases (irritable bowel syndrome), from acid-related diseases (gastro esophageal reflux) to tumors.
Endoscopy uses a flexible tube with a camera to explore the entire digestive tract, from mouth to rectum.
Innovation in endoscopy translates into early diagnosis, non-invasive diagnosis, minimally invasive treatment and increased interaction with patients.
Screening for colorectal cancer
“Although some endoscopic maneuvers are not pleasant, they really save your life. In this regard, we are investing heavily in screening for colon cancer, which, together with breast cancer, is probably the most important in the world. This program is the only one able to identify the cancer precursor and therefore allows an early diagnosis to be made to patients who have never had the tumor but who are carriers of it. The precursor is a polyp, a benign lesion that in some cases can become a tumor. We know that not all polyps become tumors, but all colon tumors come from one polyp. The aim is therefore to identify all polyps, remove them and thus prevent the onset of colon cancer.
This screening is in great expansion all over the world, some geographical areas are still excluded and unfortunately also some regions of southern Italy,” explained Professor Repici.
The variability of the human factor and the role of artificial intelligence
“After 50 years, 20% of the Western population has at least one polyp and a European patient dies every 3 minutes from a colon tumor. However, it is not always easy to identify the polyp through colonoscopy and this is where the human factor comes into play; in fact, we have many diagnostic tools and technologies that allow us to improve our work, but the variability of the operator remains a significant element that interferes on the path of diagnosis and affects the effectiveness of the screening. Unfortunately, the data show that out of one hundred colonoscopies we still have between 10 and 18% of missing rate, or polyps that go undetected.
Screening for colon cancer cannot afford to depend on human variability, which is why we are increasingly moving towards artificial intelligence. Any form of digitization and performance improvement, however, can never do without colonoscopy: the polyp can be identified in other ways (liquid biopsy, fecal test, capsule endoscopy), but only through colonoscopy will it be possible to remove it in the future. Endoscopy is a booming industry because it is a real gateway to our body without any traumatic approach and allows you to perform multiple operations, such as leaving a pacemaker in your stomach, implanting capsules that release drugs, insert clips and stents.
Through artificial intelligence, we want to develop new technologies to eliminate the number of undetected polyps; improve lesion characterization prior to histological examination; and improve the colon cancer-screening program.
Humanitas University is engaged in a project with other companies to bring artificial intelligence into the world of colonoscopy in the short term. We are working on a clinical validation study of this system and I believe that at the beginning of 2019 the colonoscopy will be carried out with the help of artificial intelligence”, Professor Repici hopes.
Watch the full speech by Professor Alessandro Repici, click here.