- The lifetime risk of developing colorectal cancer is about 5%
- Increasing age and a family history of colorectal cancer are the greatest risk factors for the disease
- Patients presenting with suspicious symptoms and signs should be referred and investigated urgently in a specialised unit
- Colonoscopy and computed tomographic colonography are of equal sensitivity for detection of colorectal cancer
- Colonoscopy allows biopsy of suspicious lesions and removal of polyps
- Population screening by testing for faecal occult blood has begun in the United Kingdom
Colorectal cancer is common, the presenting symptoms are non-specific, and the stage of disease at diagnosis is closely related to survival. In this review we discuss disease presentation, criteria for urgent referral of patients to specialist care, and recent developments in the implementation of national screening programmes, which aim to reduce mortality from this common disease. Many general practitioners will also refer patients with suspected colorectal cancer ?direct to test? and this review covers the various modalities for investigation of patients with colorectal symptoms.