December 2021: We updated recommendation 1.3.9 to say that transanal total mesorectal excision should be used only in research, in line with the new NICE interventional procedures guidance on transanal total mesorectal excision for rectal cancer.
January 2020: This guideline is an update of NICE guideline CG131 (published November 2011) and NICE guideline CSG5 (published June 2004) and has replaced them.
Minor changes since publication
January 2022: Minor changes to redirect NICE Pathways links.
July 2021: We clarified recommendation 1.1.1 to consider daily aspirin to reduce the risk of colorectal cancer in people with Lynch syndrome. We also removed the aspirin doses to clarify that we are not recommending a particular dose.
May 2021: Link added to the NICE Pathway on colorectal cancer for information on genomic biomarker-based therapy in solid tumour treatment pathways.
August 2020: A link to the NICE surveillance review of a follow-up study to the randomised controlled trial which recommendation 1.1.1 was based on was added to the rationale and impact section.