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Management of colorectal cancer

### What you need to know

Colorectal cancer represents the third most commonly diagnosed cancer and is the fourth most common cause of cancer related mortality globally.1 The highest incidence and mortality rates are seen in high income countries.2

Surgical resection is the mainstay of treatment. Systemic chemotherapy and local pelvic radiotherapy are important adjuvant treatment modalities. The primary care physician plays a critical role in coordinating increasingly complex multi-modal management strategies for patients with colorectal cancer. This article provides an overview of contemporary management of colorectal cancer for general practitioners and other non-specialists.

The presentation and diagnosis of colorectal cancers have been covered recently in another article in The BMJ .3

Endoscopic biopsy followed by histology of the specimen is essential to confirm a new diagnosis of colorectal cancer. Following this, several investigations are necessary for clinical staging. These inform prognosis and guide subsequent management. Some can be arranged by the primary care physician.

### Primary care physicians

UK and Australian guidelines45 advise obtaining a computed tomography (CT) scan of the chest, abdomen, and pelvis to assess the extent of local …