Colorectal cancer (CRC) is one of the main alimentary tract system malignancies affecting people worldwide. Adenomatous polyps are precursors of CRC, and therefore, preventing the development of these lesions may also prevent subsequent malignancy. However, the adenoma detection rate (ADR), a measure of the ability of a colonoscopist to identify and remove precancerous colorectal polyps, varies significantly among endoscopists. Here, we attempt to use a convolutional neural network (CNN) to generate a unique computer-aided diagnosis (CAD) system by exploring in detail the multiple-scale performance of deep neural networks. We applied this system to 3,375 hand-labeled images from the screening colonoscopies of 1,197 patients; of whom, 3,045 were assigned to the training dataset and 330 to the testing dataset. The images were diagnosed simply as either an adenomatous or non-adenomatous polyp. When applied to the testing dataset, our CNN-CAD system achieved a mean average precision of 89.5%. We conclude that the proposed framework could increase the ADR and decrease the incidence of interval CRCs, although further validation through large multicenter trials is required.
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