Gastroenterology Search
Gastroenterology Gastroenterology
colorectal%20cancer
COLORECTAL CANCER
Treatment Guideline Chart
Colorectal cancer is a carcinoma arising from the luminal surface of the colon.
It is the 2nd most common cancer in women and third most common cancer in male worldwide. It commonly arises from adenomatous polyps.
It is strongly linked to age with 83% occurring in people ≥60 years old.
Rectal cancer is defined as cancerous lesions located within 12 cm of the anal verge.

Colorectal Cancer References

  1. Alberts SR, Citrin D, Rodriguez-Bigas M, Das P. Colon, rectal, and anal cancers. In: Pazdur R, Wagman LD, Camphausen KA, Hoskins WJ, eds. Cancer management: a multidisciplinary approach. 12th ed. Connecticut, CT: CMPMedica; 2009:329-363.
  2. Clark JW, Grothey A. Systemic chemotherapy for nonoperable metastatic colorectal cancer: treatment recommendations. UpToDate Web site. http://www.uptodate.com/. 11 Dec 2013.
  3. Australian Cancer Network Colorectal Cancer Guidelines Revision Committee. Guidelines for the prevention, early detection and management of colorectal cancer. The Cancer Council Australia and Australian Cancer Network, Sydney. http://www.nhmrc.gov.au/. 2005.
  4. Brink D, Barlow J, Bush K, et al. Colorectal cancer screening. Institute for Clinical Systems Improvement Web site. https://www.icsi.org/. 2012 May.
  5. American Cancer Society. Colorectal cancer early detection. American Cancer Society Web site. http://www.cancer.org/. 2013.
  6. Fitzgerald A, Frizelle F, Jeffery M, et al. Summary of guidance for the management of early bowel cancer. NZ Med J. 2011;124(1337):1-10. http://journal.nzma.org.nz/.
  7. Glimelius B, Tiret E, Cervantes A, Arnold D, on behalf of the ESMO Guidelines Working Group. Rectal cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2013 Oct;24(Suppl 6):vi81-vi88. http://annonc.oxfordjournals.org/.
  8. Labianca R, Nordlinger B, Beretta GD, et al on behalf of the ESMO Guidelines Working Group. Early colon cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2013 Oct;24(Suppl 6):vi64-vi72. http://annonc.oxfordjournals.org/. PMID: 24078664
  9. National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: colon cancer version 1.2015. NCCN Web site. http://www.nccn.org/. 20 Aug 2014. Accessed 10 Sep 2014.
  10. National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: colon cancer version 3.2014. NCCN Web site. http://www.nccn.org/. 27 Jan 2014. Accessed 10 Feb 2014.
  11. National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: colorectal cancer screening. NCCN Web site. http://www.nccn.org/. 07 Jan 2013. Accessed 10 Feb 2014.
  12. National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: rectal cancer version 1.2015. NCCN Web site. http://www.nccn.org/. 20 Aug 2014. Accessed 17 Sep 2014.
  13. National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: rectal cancer version 3.2014. NCCN Web site. http://www.nccn.org/. 27 Jan 2014. Accessed 10 Feb 2014.
  14. National Institute for Health and Clinical Excellence. The diagnosis and management of colorectal cancer: full guideline. NICE Web site. http://www.nice.org.uk/. 2011 Nov.
  15. Scottish Intercollegiate Guideline Network. Diagnosis and management of colorectal cancer: a national clinical guideline. SIGN Web site. http://sign.ac.uk/. 2011 Dec.
  16. Starlinger P, Alidzanovic L, Schauer D, et al. Neoadjuvant bevacizumab persistently inactivates VEGF at the time of surgery despite preoperative cessation. Br J Cancer. 2012 Sep 4;107(6):961-966. doi: 10.1038/bjc. PMID: 22850548
  17. Van Cutsem E, Nordlinger B, Cervantes A, on behalf of the ESMO Guidelines Working Group. Advanced colorectal cancer: ESMO clinical practice guidelines for treatment. Ann Oncol. 2010 May;21(Suppl 5):v93-v97. http://annonc.oxfordjournals.org/. PMID: 20555112
  18. National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: colon cancer version 2.2015. NCCN web site. http://www.nccn.org/. 03 Oct 2014. Accessed 10 Mar 2015.
  19. National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: rectal cancer version 2.2015. NCCN web site. http://www.nccn.org/. 09 Dec 2014. Accessed 10 Mar 2015.
  20. National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: colorectal cancer screening version 1.2014. NCCN web site. http://www.nccn.org/. 19 May 2014. Accessed 10 Mar 2015.
  21. National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: colon cancer version 2.2016. NCCN website. https://www.nccn.org/professionals/physician_gls/pdf/colon.pdf. 2016.
  22. Scottish Intercollegiate Guidelines Network (SIGN). Diagnosis and management of colorectal cancer: a national clinical guideline. SIGN website. http://sign.ac.uk/pdf/sign126.pdf. Revised 2015.
  23. Spada C, Stoker J, Alarcon O, et al; European Society of Gastrointestinal Endoscopy; European Society of Gastrointestinal and Abdominal Radiology. Clinical indications for computed tomographic colonography: European Society of Gastrointestinal Endoscopy (ESGE) and European Society of Gastrointestinal and Abdominal Radiology (ESGAR) Guideline. Endoscopy. 2014 Oct;46(10):897-915. doi: 10.1055/s-0034-1378092. PMID: 25268304
  24. US Preventive Services Task Force, Bibbins-Domingo K, Grossman DC, et al. Screening for colorectal cancer: US Preventive Services Task Force recommendation statement. JAMA. 2016 Jun;315(23):2564-2575. doi: 10.1001/jama.2016.5989. PMID: 27304597
  25. Van Cutsem E, Cervantes A, Adam R, et al. ESMO consensus guidelines for the management of patients with metastatic colorectal cancer. Ann Oncol. 2016 Aug;27(8):1386-1422. https://annonc.oxfordjournals.org/. Accessed 25 Aug 2016. PMID: 27380959
  26. National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology:genetic/familial high-risk assessment: colorectal version 1.2016. https://www.nccn.org/. Jun 2016. Accessed 28 Oct 2016.
  27. Christensen IJ, Brünner N, Dowell B, et al. Plasma TIMP-1 and CEA as markers for detection of primary colorectal cancer: A prospective validation study including symptomatic and non-symptomatic individuals. Anticancer Res. 2015 Sep;35(9):4935-4941. PMID: 26254391
  28. Marcae FA, Bendell J. Clinical presentation, diagnosis, and staging of colorectal cancer. UptoDate. www.uptodate.com. Mar 2018.
  29. National Comprehensive Cancer Network. NCCN clinical practice guidelines on colon cancer. Version 3.2018. NCCN. www.nccn.org. 7 Aug 2018.
  30. National Comprehensive Cancer Network. NCCN clinical practice guidelines on rectal cancer. version 3.2018. NCCN. www.nccn.org. 7 Aug 2018.
  31. Seitz U, Bohnacker S, Binmoeller KF. Endoscopic removal of large colon polyps. UptoDate. www.uptodate.com. Mar 2018.
  32. German Guideline Program in Oncology (German Cancer Society, German Cancer Aid, AWMF). Evidenced-based guideline for colorectal cancer. Version 2.1. German Cancer Society. https://www.leitlinienprogramm-onkologie.de/. Jan 2019.
  33. Lopes G, Stern MC, Temin S, et al. Early detection for colorectal cancer: ASCO resource-stratified guideline. J Glob Oncol. 2019 Feb;5:1-22. doi: 10.1200/JGO.18.00213. PMID: 30802159
  34. Ministry of Health Malaysia. Clinical practice guidelines: Management of colorectal carcinoma. Ministry of Health Malaysia. http://www.moh.gov.my/. 2017.
  35. National Cancer Institute. Colon cancer treatment (PDQ®) - health professional version. National Cancer Institute. https://www.cancer.gov/. 22 Jan 2020.
  36. National Cancer Institute. Colorectal cancer screening (PDQ®) - health professional version. National Cancer Institute. https://www.cancer.gov/. 31 Oct 2019.
  37. National Cancer Institute. Rectal cancer treatment (PDQ®) - health professional version. National Cancer Institute. https://www.cancer.gov/. 29 Jan 2019.
  38. National Comprehensive Cancer Network (NCCN). NCCN clinical practice guidelines in oncology (NCCN guidelines): Colon cancer. Version 1.2020. NCCN. https://www.nccn.org/. 19 Dec 2019.
  39. National Comprehensive Cancer Network (NCCN). NCCN clinical practice guidelines in oncology (NCCN guidelines): Colon cancer. Version 2.2020. NCCN. https://www.nccn.org/. 03 Mar 2020.
  40. National Comprehensive Cancer Network (NCCN). NCCN clinical practice guidelines in oncology (NCCN guidelines): Colorectal cancer screening. Version 2.2019. NCCN. https://www.nccn.org/. 02 Aug 2019.
  41. National Comprehensive Cancer Network (NCCN). NCCN clinical practice guidelines in oncology (NCCN guidelines): Rectal cancer. Version 1.2020. NCCN. https://www.nccn.org/. 19 Dec 2019.
  42. National Comprehensive Cancer Network (NCCN). NCCN clinical practice guidelines in oncology (NCCN guidelines): Rectal cancer. Version 2.2020. NCCN. https://www.nccn.org. 03 Mar 2020.
  43. National Institute for Health and Care Excellence. Colorectal cancer. NICE. https://www.nice.org.uk/. 29 Jan 2020.
  44. National Institute for Health and Care Excellence. Managing metastatic colorectal cancer. NICE. https://www.nice.org.uk/. 03 Mar 2020.
  45. Sánchez-Gundin J, Fernández-Carballido AM, Martínez-Valdivieso L, et al. New trends in the therapeutic approach to metastatic colorectal cancer. Int J of Med Sci. 2018 Apr;15(7):659-665. doi: 10.7150/ijms.24453. PMID: 29910669
  46. Vogel JD, Eskicioglu C, Weiser MR, et al. The American Society of Colon and Rectal Surgeons clinical practice guidelines for the treatment of colon cancer. Dis Colon Rectum. 2017 Oct;60(10):999-1017. doi: 10.1097/DCR.0000000000000926. PMID: 28891842
  47. Wolf AMD, Fontham ETH, Church TR, et al. Colorectal cancer screening for average-risk adults: 2018 guideline update from the American Cancer Society. CA Cancer J Clin. 2018 Jul;68(4):250-281. doi: 10.3322/caac.21457. PMID: 29846947
  48. Yoshino T, Arnold D, Taniguchi H, et al. Pan-Asia adapted ESMO consensus guidelines for the management of patients with metastatic colorectal cancer: a JSMO-ESMO initiative endorsed by CSCO, KACO, MOS, SSO and TOS. Ann Oncol. 2018 Jan;29(1):44-70. doi: 10.1093/annonc/mdx738. PMID: 29155929
  49. National Comprehensive Cancer Network (NCCN). NCCN clinical practice guidelines in oncology (NCCN guidelines): Colon cancer. Version 3.2020. NCCN. https://www.nccn.org/. 06 May 2020.
  50. National Comprehensive Cancer Network (NCCN). NCCN clinical practice guidelines in oncology (NCCN guidelines): Rectal cancer. Version 3.2020. NCCN. https://www.nccn.org/. 06 May 2020.
  51. American Cancer Society. Colorectal cancer early detection, diagnosis, and staging. American Cancer Society. www.cancer.org/. 29 Jun 2020.
  52. American Cancer Society. Treating colorectal cancer. American Cancer Society. www.cancer.org/. 29 Jun 2020.
  53. Argilés G, Tabernero J, Labianca R, et al. Localised colon cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2020 Oct;31(10):1291-1305. doi: 10.1016/j.annonc.2020.06.022. PMID: 32702383
  54. Cancer Therapy Advisor. Colon cancer treatment regimens. Cancer Therapy Advisor. https://www.cancertherapyadvisor.com/. Oct 2020.
  55. Chiorean EG, Nandakumar G, Fadelu T, et al. Treatment of patients with late-stage colorectal cancer: ASCO resource-stratified guideline. JCO Glob Oncol. 2020 Mar;6:414-438. doi: 10.1200/JGO.19.00367. PMID: 32150483
  56. National Comprehensive Cancer Network (NCCN). NCCN clinical practice guidelines in oncology (NCCN guidelines): Colon cancer. Version 4.2020. NCCN. https://www.nccn.org/. 15 Jun 2020.
  57. National Comprehensive Cancer Network (NCCN). NCCN clinical practice guidelines in oncology (NCCN guidelines): Colorectal cancer screening. Version 2.2020. NCCN. https://www.nccn.org/. 08 Jun 2020.
  58. National Comprehensive Cancer Network (NCCN). NCCN clinical practice guidelines in oncology (NCCN guidelines): Rectal cancer. Version 6.2020. NCCN. https://www.nccn.org/. 25 Jun 2020.
  59. Wo JY, Anker CJ, Ashman JB, et al. Radiation therapy for rectal cancer: Executive summary of an ASTRO clinical practice guideline. Practical Radiation Oncology. 2020 Oct;1-13. doi: 10/1016/j.prro.2020.08.004.
  60. National Comprehensive Cancer Network (NCCN). NCCN clinical practice guidelines in oncology (NCCN guidelines): Colon cancer. Version 1.2021. NCCN. https://www.nccn.org/. 22 Dec 2020.
  61. National Comprehensive Cancer Network (NCCN). NCCN clinical practice guidelines in oncology (NCCN guidelines): Rectal cancer. Version 1.2021. NCCN. https://www.nccn.org/. 22 Dec 2020.
  62. National Comprehensive Cancer Network (NCCN). NCCN clinical practice guidelines in oncology (NCCN guidelines): Colon cancer. Version 2.2021. NCCN. https://www.nccn.org/. 21 Jan 2021.
  63. National Comprehensive Cancer Network (NCCN). NCCN clinical practice guidelines in oncology (NCCN guidelines): Colon cancer. Version 2.2021. NCCN. https://www.nccn.org/. 21 Jan 2021.
  64. National Comprehensive Cancer Network (NCCN). NCCN clinical practice guidelines in oncology (NCCN guidelines): Colon cancer. Version 3.2021. NCCN. https://www.nccn.org/. 10 Sep 2021.
  65. National Comprehensive Cancer Network (NCCN). NCCN clinical practice guidelines in oncology (NCCN guidelines): Colorectal cancer screening. Version 2.2021. NCCN. https://www.nccn.org/. 13 Apr 2021. Accessed 12 Oct 2021.
  66. National Comprehensive Cancer Network (NCCN). NCCN clinical practice guidelines in oncology (NCCN guidelines): Rectal cancer. Version 2.2021. NCCN. https://www.nccn.org/. 10 Sep 2021.
Editor's Recommendations
Special Reports
MORE Special Reports arrow
Related Disease News
MORE Disease News arrow