Colorectal cancer: management

Abstract

Colorectal cancer is the fourth most common cause of cancer, contributing to 11% of all cancers, and the second most common cause of cancer death worldwide. The lifetime risk is greater in developed countries compared with lesser-developed countries, with survival influenced by stage of disease, socioeconomic factors and healthcare access. Early detection through bowel screening programmes in asymptomatic populations, risk stratification of symptomatic populations and surveillance of high-risk groups aim to identify early-stage disease. Specialist surgery, despite the associated morbidity and mortality, offers the best chance of cure for non-metastatic disease. Isolated metastatic disease is increasingly resected, with good results. This article summarizes the management of colorectal cancer, with a focus on early rectal and polyp cancers, which can pose management dilemmas.