AI Use in Colonoscopy Linked to Decline in Doctors' Cancer Detection Skills

Some doctors got worse at detecting cancer after relying on AI

We've heard about upskilling and re-skilling due to AI -- but how about de-skilling? A new study published this week found that doctors who frequently use AI to detect cancer in one medical procedure got significantly worse at doing so. The researchers set out to discover whether continuous exposure to AI impacted doctors' behavior when conducting colonoscopy, so they decided to assess "how endoscopists who regularly used AI performed colonoscopy when AI was not in use." The answer: Not so hot. The rate was about six percentage points lower. The study was published in The Lancet Gastroenterology & Hepatology journal by medical professionals and researchers in countries including Poland, Norway, Sweden, the U.K., and Japan. It followed doctors at four endoscopy centers in Poland, which were part of a trial program focusing on AI's use in colonoscopy for potential cancer prevention. It raises questions about the use of AI in healthcare, when it helps and when it could hurt. Last week, The Verge reported on a Google healthcare AI model's instance of potentially hallucinating a body part and where medical professionals think the industry will go from here.

Doctors risk being 'deskilled' by relying too much on AI

When doctors use AI image recognition technology to spot and remove precancerous growths known as adenomas during colonoscopies, the detection rate is higher. But take the AI away, and their rate drops to below where it was in the first place. One recent study shows that using this AI tool results in a 12.5 percent increase in the adenoma detection rates (ADR). That is expected to save lives. But when doctors lose access to AI assistance, their ability to spot adenomas tends to drop below what it was before they started relying on AI, according to a study published in The Lancet Gastroenterology & Hepatology. "Continuous exposure to AI might reduce the ADR of standard non-AI assisted colonoscopy, suggesting a negative effect on endoscopist behaviour," the study concludes. The analysis, based on data from four endoscopy centers in Poland between September 2021 and March 2022, compares the change in ADR of standard, non-AI assisted colonoscopy before and after endoscopists were exposed to AI in their clinics. "The ADR of standard colonoscopy decreased significantly from 28.4 percent (226 of 795) before to 22.4 percent (145 of 648) after exposure to AI, corresponding with an absolute difference of minus 6.0 percent," the study says. The 21 authors of the Lancet paper note that in 2019, the European Society of Gastrointestinal Endoscopy (ESGE) warned about the risk of "deskilling" in its AI guidelines [PDF]. "Possible significant risks with implementation, specifically endoscopist deskilling and over-reliance on artificial intelligence, unrepresentative training datasets, and hacking, need to be considered," the ESGE said. The authors say they believe their study is the first to look at the effect of continuous AI exposure on clinical outcomes and they hope the findings prompt further research into the impact of AI on healthcare. AI, for all its purported benefits in efficiency, may impose a cost on the people who use it. In June, MIT researchers published a related study that found the use of LLM chatbots associated with lower brain activity. Concern about "deskilling" due to automation dates back decades. As noted in a recent paper from Purdue researchers, psychologist Lisanne Bainbridge's 1983 work "Ironies of Automation" explored how the automation of industrial processes may expand problems for human system operators rather than solve them. The Purdue academics argue the situation is similar for designers who come to rely on AI. "Our findings suggest that while AI-driven automation is perceived as a means of increasing efficiency, excessive delegation may unintentionally hinder skill development," they conclude. Princeton University computer scientist Arvind Narayanan recently argued that developer deskilling as a result of AI is a concern. It's not like compilers eliminating people's ability to write machine code, a fear expressed years ago that never happened. "On the other hand, if a junior developer relies too much on vibe coding and hence can't program at all by themselves, in any language, and doesn't understand the principles of programming, that definitely feels like a problem," he said. ®

AI use in colonoscopy may weaken doctors' detection skills over time

The LancetAug 13 2025 The introduction of artificial intelligence (AI) to assist colonoscopies is linked to a reduction in the ability of endoscopists (health professionals who perform colonoscopies) to detect precancerous growths (adenomas) in the colon without AI assistance, according to a paper published in The Lancet Gastroenterology & Hepatology journal. Colonoscopy enables detection and removal of adenomas, leading to prevention of bowel cancer. Numerous trials have shown the use of AI to assist colonoscopies increases the detection of adenomas, generating much enthusiasm for the technology. However, there is a lack of research into how continuous use of AI affects endoscopist skills with suggestions it could be either positive, by training clinicians, or negative, leading to a reduction in skills. To our knowledge this is the first study to suggest a negative impact of regular AI use on healthcare professionals' ability to complete a patient-relevant task in medicine of any kind. Our results are concerning given the adoption of AI in medicine is rapidly spreading. We urgently need more research into the impact of AI on health professional's skills across different medical fields. We need to find out which factors may cause or contribute to problems when healthcare professionals and AI systems don't work well together, and to develop ways to fix or improve these interactions." Dr. Marcin Romańczyk, Author, Academy of Silesia (Poland) The study took place at four colonoscopy centres in Poland between September 2021 and March 2022. Regular AI use was introduced at the centres at the end of 2021 after which colonoscopies were randomly done either with or without AI assistance. During this time 1,443 colonoscopies were conducted without AI; 795 before the introduction of regular AI use and 648 after AI implementation. The colonoscopies were performed by 19 experienced endoscopists who had conducted over 2,000 colonoscopies each. The average rate of adenoma detection at non-AI assisted colonoscopies significantly decreased from 28.4% (226/795) before AI exposure to 22.4% (145/648) after AI exposure, corresponding to a 20% relative and 6% absolute reduction in adenoma detection rate. In the AI-assisted colonoscopies there was a 25.3% (186/734) adenoma detection rate. Author Prof Yuichi Mori, University of Oslo (Norway) says, "These results pose an interesting question about previous randomised controlled trials which found AI-assisted colonoscopy enabled a higher adenoma detection rate than non-AI assisted colonoscopy. It could be the case that non-AI assisted colonoscopy assessed in these trials is different from standard non-AI assisted colonoscopy as the endoscopists in the trials may have been negatively affected by continuous AI exposure." The authors acknowledge some limitations, including that the observational nature of the study means that factors other than the implementation of AI use may have influenced the findings. Additionally, as the study was conducted with experienced endoscopists this may limit its generalisation to all endoscopists - further studies with less experienced health professionals are needed to see if long term AI tool use has a larger impact on their ability to detect of adenomas without AI. Writing in a linked Comment, Dr. Omer Ahmad, University College London, who was not involved in the study, said: "These findings temper the current enthusiasm for rapid adoption of AI based technologies [...] and highlight the importance of carefully considering possible unintended clinical consequences. Although previous experimental studies have alluded to negative modification of behaviour after AI exposure, the study by Budzyń and colleagues provides the first real-world clinical evidence for the phenomenon of deskilling, potentially affecting patient-related outcomes. [...] Although AI continues to offer great promise to enhance clinical outcomes, we must also safeguard against the quiet erosion of fundamental skills required for high-quality endoscopy." The Lancet Journal reference: Budzyń, K., et al. (2025). Endoscopist deskilling risk after exposure to artificial intelligence in colonoscopy: a multicentre, observational study. The Lancet Gastroenterology & Hepatology. doi.org/10.1016/S2468-1253(25)00133-5

Doctors Were Worse at Spotting Cancer After Leaning on AI, Study Finds

Artificial intelligence tools have been shown to help doctors detect pre-cancerous growths in the colonâ€"but don't even think about taking those tools away once you've introduced them. A new study published this week in The Lancet found that doctors who are given AI tools to assist with identifying potential cancer risks in patients get worse at making those same observations when they go back to doing it without AI's help. The study looked at four endoscopy centers in Poland, tracking the success rates of detecting colon cancer for three months before AI tools were introduced and three months after. Once AI was introduced, colonoscopies were randomly assigned to either receive AI support or not. The researchers found that doctors who gave colonoscopies without AI after having its assistance available saw their detection rates drop, producing outcomes 20% worse than what they were before AI was introduced. Making the results all the more troubling is the fact that the 19 doctors who participated in the study were all very experienced and had performed more than 2,000 colonoscopies each. If those doctors can fall prey to de-skilling, seeing their own abilities erode because of reliance on AI tools, the outcomes from inexperienced doctors could be even worse. There is little doubt that AI tools can help in medical settings. There have been numerous studies that suggest that AI can facilitate everything from the detection of cancers to the diagnosis of illnesses based on a patient's medical history. Analyzing information based on a whole wealth of previous examples is kinda the bread and butter of AI (you know, as opposed to generating braindead content slop), and there is evidence that suggests that humans can augment their own abilities by using AI tools. Studies in medical settings have found that doctors who use these tools can produce better outcomes for their patients. But no one, including doctors, is immune to the risk of shutting your brain off and relying on AI rather than their own skills. Earlier this year, Microsoft published a study that found knowledge workers who lean on AI stop thinking critically about the work they are doing and feel confident that the assistance from AI will be enough to get the job done. Researchers at MIT similarly found that relying on ChatGPT for essay writing resulted in less critical engagement with the material. In the long term, there's a real risk that reliance on AI will erode our ability to problem solve and reason, which is not ideal when AI continues to generate bad information. The American Medical Association found that about two in three physicians have already adopted AI to augment their abilities. Hopefully, they're still able to identify when it does something like hallucinating a body part that doesn't exist.

Using AI Made Doctors Worse at Spotting Cancer Without Assistance

Health practitioners, companies, and others have for years hailed the potential benefits of AI in medicine, from improving medical imaging to outperforming doctors at diagnostic assessments. The transformative technology has even been predicted by AI enthusiasts to one day help find a "cure to cancer." But a new study has found that doctors who regularly used AI actually became less skilled within months. The study, which was published on Wednesday in the Lancet Gastroenterology and Hepatology journal, found that over the course of six months, clinicians became over-reliant on AI recommendations and became themselves "less motivated, less focused, and less responsible when making cognitive decisions without AI assistance."

Doctors Using AI Quickly Lose Ability to Spot Cancer, Study Finds

For years now, AI cancer detection has been touted as being as good as or better than doctors -- but given the results of a recent trial, for some doctors, AI seems to have greatly hampered their abilities instead. In a new study published in the journal The Lancet Gastroenterology and Hepatology, researchers led by the Medical University of Silesia in Poland found, upon surveying 19 doctors from four endoscopy practices between September 2021 and March 2022, that the clinicians working there seem to have gotten lazier and worse at their jobs as a result of the technology's assistance. Researchers warned of a "deskilling" effect after noticing a 20 percent relative drop in the detection rate of adenomas, or pre-cancerous growths in the colon, after an AI was introduced at the centers at the end of 2021, compared to detection rates before the AI was implemented. Notably, these results appear to challenge other studies and trials that suggested AI may be better at diagnostics than human doctors -- and the people behind this new research are now questioning why those differences exist. "These results pose an interesting question about previous randomized controlled trials which found AI-assisted colonoscopy enabled a higher adenoma detection rate than non-AI assisted colonoscopy," noted coauthor and University of Oslo health economics researcher Yuichi Mori in a statement. "It could be the case that non-AI assisted colonoscopy assessed in these trials is different from standard non-AI assisted colonoscopy as the endoscopists in the trials may have been negatively affected by continuous AI exposure." There are, of course, limitations to the study. For one, the AI tools used by the endoscopists are never named, and it's hard to gauge whether the tech may have improved since late 2021. For another, the sample size was quite small, and as Mori noted, it was observational, which means they were simply observing and collecting data without any intervention. In a comment published alongside the trial, endocrinologist Omer Ahmad of the University of College London, who was not involved in the study, suggested that this study could represent a counter to the "current enthusiasm for rapid adoption of AI-based technologies." "Although previous experimental studies have alluded to negative modification of behaviour after AI exposure... provides the first real-world clinical evidence for the phenomenon of deskilling, potentially affecting patient-related outcomes," Ahmad said. "Although AI continues to offer great promise to enhance clinical outcomes, we must also safeguard against the quiet erosion of fundamental skills required for high-quality endoscopy." Worse yet, Mori told Bloomberg that the effects of "deskilling" could become more pronounced and will "probably be higher" as AI tech improves over time. Though we haven't heard much about medical AI making doctors more effective, we have seen a lot about AI harming thinking skills in general. Could it be that the same effect is occurring in hospitals? More study is necessary before we can come up with any definitive answers, but it's not looking as promising as it once did.

Reliance on AI is making health workers less capable

Relying on artificial intelligence could be making health workers less capable, a study has suggested. It is the first research to assess "the phenomenon of deskilling" in medics who have been using AI. The study followed health care workers in Poland carrying out a diagnostic test for the early signs of bowel cancer. Endoscopists, who can include doctors or specially trained nurses, perform a test called a colonoscopy to look for precancerous growths in the bowel known as adenomas. These pre-cancerous growths can be detected and removed, preventing them from becoming bowel cancer. AI oversight Advances in AI technology have led to the development of computer-assisted polyp detection systems, which have been found to help these health workers spot more adenomas. Experts wanted to assess whether the continuous use of AI to help in the procedure had led to a dip in results when endoscopists performed the colonoscopies without AI. The research team analysed 1,442 colonoscopies conducted by 19 experienced health workers before and after AI systems were rolled out at certain centres in 2021. The study, published in the Lancet Gastroenterology and Hepatology journal, found that the rate of detection of the precancerous polyps was 6 per cent lower after the introduction of AI in standard and non-AI assisted colonoscopies. The average rate of detection of the growths during colonoscopies was 28.4 per cent before AI began to be used. After this time, the rate fell to 22.4 per cent among medics conducting non-AI colonoscopies. At the same time, the procedures that were AI-assisted had a detection rate of 25.3 per cent. Researchers said the finding was "concerning", given the rapid uptake of AI across healthcare. Urgent research needed Dr Marcin Romanczyk, one of the study authors from the Academy of Silesia in Poland, said: "To our knowledge this is the first study to suggest a negative impact of regular AI use on healthcare professionals' ability to complete a patient-relevant task in medicine of any kind. "Our results are concerning given the adoption of AI in medicine is rapidly spreading," he said. "We urgently need more research into the impact of AI on health professionals' skills across different medical fields. "We need to find out which factors may cause or contribute to problems when healthcare professionals and AI systems don't work well together, and to develop ways to fix or improve these interactions." Professor Yuichi Mori, a study author from the University of Oslo in Norway, said the findings "pose an interesting question about previous trials" that found detection rates were higher with the help of AI than without it during such tests. He said: "The endoscopists in the trials may have been negatively affected by continuous AI exposure". In a linked editorial, Omer Ahmad, a consultant gastroenterologist, interventional endoscopist and clinical research fellow at University College London, wrote: "These findings temper the current enthusiasm for rapid adoption of AI-based technologies such as CADe and highlight the importance of carefully considering possible unintended clinical consequences. "The study provides the first real-world clinical evidence for the phenomenon of deskilling, potentially affecting patient-related outcomes."

Gut Docs Lose Their Edge Leaning On AI Assistance For Colonscopy

By Dennis Thompson HealthDay ReporterTHURSDAY, Aug. 14, 2025 (HealthDay News) -- Artificial intelligence (AI) is being touted as a means of improving doctors' effectiveness, but the new tool might dull their skills in some instances, a new study argues. Specifically, doctors became worse at performing colonoscopies after AI started assisting them, researchers reported Aug. 12 in The Lancet Gastroenterology & Hepatology. Doctors' ability to detect precancerous growths in a person's colon decreased by 20% in non-AI assisted colonoscopies, several months after AI had been introduced, researchers found. "To our knowledge this is the first study to suggest a negative impact of regular AI use on health care professionals' ability to complete a patient-relevant task in medicine of any kind," said researcher Dr. Marcin Romańczyk, an assistant professor of gastroenterology at the Academy of Silesia in Poland. "Our results are concerning given the adoption of AI in medicine is rapidly spreading," Romańczyk said in a news release. "We urgently need more research into the impact of AI on health professional's skills across different medical fields." Colon cancer is one of the few completely preventable cancers, thanks to colonoscopy. During the procedure, a medical specialist called an endoscopist runs a thin lighted tube up through a person's colon, looking for precancerous polyps. These polyps can be removed on the spot, using tools threaded through the tube. Previous studies have shown that AI can increase the detection of polyps during colonoscopy, but there's a lack of research into how relying on AI might affect an endoscopist's skills. For the study, researchers tracked colonoscopies performed at four medical centers in Poland between September 2021 and March 2022 by 19 experienced endoscopists. Regular AI use in colonoscopy had been introduced at the centers at the end of 2021, after which the procedure was randomly performed with or without AI assistance. During the study, 1,443 colonoscopies were conducted without AI assistance, including 795 before and 648 after AI had been implemented. The average rate of polyp detection during non-AI colonoscopies decreased from 28% prior to AI implementation to 22% after the doctors started using AI, results show. AI-assisted colonoscopies had a 25% detection rate. "These results pose an interesting question about previous randomized controlled trials which found AI-assisted colonoscopy enabled a higher (polyp) detection rate than non-AI assisted colonoscopy," senior researcher Yuichi Mori said in a news release. He's a professor of health management and health economics at the University of Oslo in Norway. "It could be the case that non-AI assisted colonoscopy assessed in these trials is different from standard non-AI assisted colonoscopy, as the endoscopists in the trials may have been negatively affected by continuous AI exposure," Mori said. In an accompanying editorial, Dr. Omer Ahmad of University College London wrote that "these findings temper the current enthusiasm for rapid adoption of AI based technologies [...] and highlight the importance of carefully considering possible unintended clinical consequences." Ahmad, a gastroenterologist and endoscopist who was not involved in the research, offered a further caution. "Although AI continues to offer great promise to enhance clinical outcomes, we must also safeguard against the quiet erosion of fundamental skills required for high-quality endoscopy," he concluded. More information The American Cancer Society has more on colonoscopy. SOURCE: The Lancet, news release, Aug. 12, 2025