Despite an improved understanding of the pathogenesis of colorectal ca
ncer and the technical ability to alter its natural history in a large
proportion of average and high-risk patients, this cancer remains dea
dly. There has been no significant change in incidence or survival rat
es over the past 40 years. This indicates a continued need for earlier
detection of polyps and cancers, aggressive surgery for the primary t
umor, and improved multimodality treatment for metastatic disease.