Tajiri, Hisao

ABSTRACT In response to the World Health Organization's (WHO) Global Initiative on Artificial Intelligence (AI) for Health, the World Endoscopy Organization (WEO) highlights the unique challenges and opportunities AI presents for gastrointestinal endoscopy, particularly in resource‐limited settings. While AI technologies have shown promise in improving diagnostic accuracy and efficiency in high‐resource environments, their implementation in low‐ and middle‐income countries is hindered by infrastructural, economic, regulatory, and training barriers. This commentary explores how these challenges may exacerbate existing healthcare disparities, emphasizing the need for localized datasets, affordable AI models, simplified regulatory frameworks, and workforce capacity building. The WEO supports WHO's call for equitable AI deployment and advocates for region‐specific solutions, including mobile and offline AI tools, public‐private partnerships, locally developed algorithms aligned with prevalent disease patterns, and a flexibly adapted regulatory framework. By leveraging WEO's training networks and fostering collaboration among governments, clinicians, and industry, the integration of AI into endoscopy can become more accessible and relevant to underserved populations. The commentary underscores that AI should not be seen as a luxury but as a tool to bridge global disparities in care quality. Ensuring responsible and inclusive AI integration requires both global coordination and context‐specific adaptations to truly benefit all healthcare systems.

The number of artificial intelligence (AI) tools for colonoscopy on the market is increasing with supporting clinical evidence. Nevertheless, their implementation is not going smoothly for a variety of reasons, including lack of data on clinical benefits and cost‐effectiveness, lack of trustworthy guidelines, uncertain indications, and cost for implementation. To address this issue and better guide practitioners, the World Endoscopy Organization (WEO) has provided its perspective about the status of AI in colonoscopy as the position statement. WEO Position Statement: Statement 1.1: Computer‐aided detection (CADe) for colorectal polyps is likely to improve colonoscopy effectiveness by reducing adenoma miss rates and thus increase adenoma detection; Statement 1.2: In the short term, use of CADe is likely to increase health‐care costs by detecting more adenomas; Statement 1.3: In the long term, the increased cost by CADe could be balanced by savings in costs related to cancer treatment (surgery, chemotherapy, palliative care) due to CADe‐related cancer prevention; Statement 1.4: Health‐care delivery systems and authorities should evaluate the cost‐effectiveness of CADe to support its use in clinical practice; Statement 2.1: Computer‐aided diagnosis (CADx) for diminutive polyps (≤5 mm), when it has sufficient accuracy, is expected to reduce health‐care costs by reducing polypectomies, pathological examinations, or both; Statement 2.2: Health‐care delivery systems and authorities should evaluate the cost‐effectiveness of CADx to support its use in clinical practice; Statement 3: We recommend that a broad range of high‐quality cost‐effectiveness research should be undertaken to understand whether AI implementation benefits populations and societies in different health‐care systems.

Severe Acute Respiratory Syndrome Corona Virus 2 (SARS‐CoV‐2) is the etiologic agent causing the disease Corona Virus Disease 19 (COVID‐19), resulting in a worldwide pandemic. Non‐emergent endoscopy services have been disrupted as incidence and hospitalizations were rising. It is anticipated that the peak incidence may be leveling off in many parts of the world, but there is a concern for resurgence of the virus activity. Thus, it is important for endoscopy units to have plans in place during peak times of the epidemic and when resuming endoscopic services as the pandemic wanes. The global endoscopy community is faced with the challenge of providing care during this time. The WEO‐COVID guidance task force has provided this resource document based on the current evidence and consensus opinion. These World Endoscopy Organization (WEO) recommendations are meant to guide endoscopists worldwide, should be interpreted in light of specific clinical conditions and resource availability and may not apply in all situations. This guidance document does not supersede the need to check for all local regulations and legislations.