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Polyps are well-known cancer precursors identified by colonoscopy. However, variability in their size, location, and surface largely affect identification, localisation, and characterisation. Moreover, colonoscopic surveillance and removal of polyps (referred to as polypectomy ) are highly operator-dependent procedures. There exist a high missed detection rate and incomplete removal of colonic polyps due to their variable nature, the difficulties to delineate the abnormality, the high recurrence rates, and the anatomical topography of the colon. There have been several developments in realising automated methods for both detection and segmentation of these polyps using machine learning. However, the major drawback in most of these methods is their ability to generalise to out-of-sample unseen datasets that come from different centres, modalities and acquisition systems. To test this hypothesis rigorously we curated a multi-centre and multi-population dataset acquired from multiple colonoscopy systems and challenged teams comprising machine learning experts to develop robust automated detection and segmentation methods as part of our crowd-sourcing Endoscopic computer vision challenge (EndoCV) 2021. In this paper, we analyse the detection results of the four top (among seven) teams and the segmentation results of the five top teams (among 16). Our analyses demonstrate that the top-ranking teams concentrated on accuracy (i.e., accuracy > 80% on overall Dice score on different validation sets) over real-time performance required for clinical applicability. We further dissect the methods and provide an experiment-based hypothesis that reveals the need for improved generalisability to tackle diversity present in multi-centre datasets.Author contributions S. Ali conceptualised the work, led the challenge and workshop, prepared the dataset, software and performed all analyses. S. Ali, N. Ghatwary and D. Jha contributed in data annotations. T. de Lange, J.E. East, S. Realdon, R. Cannizzaro, D. Lamarque were involved providing colonoscopy data and in the validation and quality checks of the annotations used in this challenge. Challenge participants (E

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Colorectal cancer is one of the most common cancers with a high mortality rate. The determination of microsatellite instability (MSI) status in resected cancer tissue is vital because it helps diagnose the related disease and determine the relevant treatment. This paper presents a two-stage classification method for predicting the MSI status based on a deep learning approach. The proposed pipeline includes the serial connection of the segmentation network and the classification network. In the first stage, the tumor area is segmented from the given pathological image using the Feature Pyramid Network (FPN). In the second stage, the segmented tumor is classified as MSI-L or MSI-H using Inception-Resnet-V2. We examined the performance of the proposed method using pathological images with 10× and 20× magnifications, in comparison with that of the conventional multiclass classification method where the tissue type is identified in one stage. The F1-score of the proposed method was higher than that of the conventional method at both 10× and 20× magnifications. Furthermore, we verified that the F1-score for 20× magnification was better than that for 10× magnification.