Unlike existing fully-supervised approaches, we rethink colorectal polyp segmentation from an out-of-distribution perspective with a simple but effective self-supervised learning approach. We leverage the ability of masked autoencoders -- self-supervised vision transformers trained on a reconstruction task -- to learn in-distribution representations; here, the distribution of healthy colon images. We then perform out-of-distribution reconstruction and inference, with feature space standardisation to align the latent distribution of the diverse abnormal samples with the statistics of the healthy samples. We generate per-pixel anomaly scores for each image by calculating the difference between the input and reconstructed images and use this signal for out-of-distribution (ie, polyp) segmentation. Experimental results on six benchmarks show that our model has excellent segmentation performance and generalises across datasets. Our code is publicly available at https://github.com/GewelsJI/Polyp-OOD.
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