This guideline covers diagnosing and managing colorectal (bowel) cancer in people aged 18 and over. It aims to improve quality of life and survival for adults with colorectal cancer through early diagnosis and staging, management of local disease according to risk of recurrence (high, moderate, low) and management of secondary tumours (metastatic disease).

In December 2014, new recommendations on surgery and colonic stents in acute large bowel obstruction and on stage I rectal cancer were added to sections 1.2.2 and 1.2.4.


This guideline includes recommendations on:

Who is it for?

  • Healthcare professionals
  • Adults with colorectal cancer, their families and carers

Is this guideline up to date?

We reviewed the evidence in February 2016 and we are extending the scope of the guideline to cover areas of the NICE guideline on improving outcomes in colorectal cancer that have been superseded by other NICE guidance. 

Guideline development process

How we develop NICE guidelines

Your responsibility

The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or service users. The application of the recommendations in this guideline is not mandatory and the guideline does not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or their carer or guardian.

Local commissioners and/or providers have a responsibility to enable the guideline to be applied when individual health professionals and their patients or service users wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with compliance with those duties.

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