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This study assesses the efficacy of detecting colorectal cancer precursors or polyps in an ex vivo human colon model with a microwave colonoscopy algorithm. Nowadays, 22% of polyps go undetected with conventional colonoscopy, and the risk of cancer after a negative colonoscopy can be up to 7.9%. We developed a microwave colonoscopy device that consists of a cylindrical ring-shaped switchable microwave antenna array that can be attached to the tip of a conventional colonoscope as an accessory. The accessory is connected to an external unit that allows successive measurements of the colon and processes the measurements with a microwave imaging algorithm. An acoustic signal is generated when a polyp is detected. Fifteen ex vivo freshly excised human colons with cancer (<i>n</i> = 12) or polyps (<i>n</i> = 3) were examined with the microwave-assisted colonoscopy system simulating a real colonoscopy exploration. After the experiment, the dielectric properties of the specimens were measured with a coaxial probe and the samples underwent a pathology analysis. The results show that all the neoplasms were detected with a sensitivity of 100% and specificity of 87.4%.