## Materials and Methods  
### Colonoscopy Database  
All collected colonoscopy images were captured with the general colonoscopes produced by Olympus Corporation of Japan (Shinjuku Monolith, 2-3-1 Nishi-Shinjuku, Shinjuku-ku, Tokyo 163-0914, Japan). Colonoscopes models were GF-260 and 290, so we can ensure that the image quality were close. Endoscopic images were obtained by gastroenterologists from Taipei Medical University Hospital, Taipei, Taiwan. A small amount of patient data was used for analysis, and decided the next method of analyzing pictures and data for the research. We analyzed data of 298 patients with MC from the database between 1 January 2016 and 17 July 2017; In the initial analysis of the study, the analysis of polyp texture in patients without tumor index such as CEAs or CA 199 was not related to pathological findings, so we included only 124 patients who had CEA data and clear colonoscopy images. We then analyzed these patients' colonoscopy images. The 124 patients' images survey indicated that if analysis is conducted using a large size image or if the reflection of feces are not avoided and the part with white text recorded in the image is not removed, it may be caused by the aforementioned interference. This can lead to unsatisfactory results. Regarding the usefulness of correcting images according to patients' normal skin and luminosity, because the calculation results are based on the gray-level symbiotic matrix analysis method, the final calculated result exerted little effect. The patient's normal skin and brightness were therefore not ultimately required for correction. We also observed that taking a polyp image consisting of 100 \(\times\) 100-pixel squares from the center point provided improved texture features and results. Next, 51,891 colonoscopy data were acquired from the Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taipei Medical University Hospital. The research encompassed the period from 1 January 2012 to 30 September 2017. The research materials and images were deidentified by the Taipei Medical University Human Research Joint Ethics Committee for research permission and ensured that research materials and images were deidentified. No informed consent is required for this retrospective study. After the adoption, relevant research and statistical work was commenced. Among them, 28,974 colonoscopy data had polyps; thus, the polyp detection rate (PDR) was 55.84%. Because 12,244 times colonoscopy data presented with adenoma or colorectal cancer, adenoma detection rate (ADR) was 23.60%. Finally, 834 patients presented with colorectal cancer, so the detection rate of colorectal cancer was 1.61%. Next, from these data, the total number of patients with a diagnosis of MC was observed to be 1092, and the MC prevalence rate was 2.1%, similar to the prevalence rate of 1.78% in Mainland China [2]. These patients included 787 women and 305 men, and therefore, the women had an incidence of MC 2.58 times that of men. The age distribution of these patients was as young as 17 and as large as 97. Of these, 96 patients were over 80 years old, and 480 patients were between 60 and 80 years old. Only three patients were younger than 20. The first patient received colonoscopy study on 2 January 2012. The last patient underwent a colonoscopy on 29 September 2017. Among these patients, 658 patients had polyps. 390 patients had colon adenoma detected by colonoscopy. 18 patients' pathology reports had colon cancer. Based on the data collected from 1092 person-times, the PDR and ADR were 60.26% and 35.71%, respectively--close to the 34.7% noted in other studies [1]. Colorectal cancer detection rate was 1.65%. Compared with data from the previous database, patients with MC had a slightly higher PDR than did patients who had received general colonoscopy (4.42%); moreover, the ADR was much higher (12.11%), and the colorectal cancer detection rate was similar.