With the increase of high protein and high fat food intake, the incidence of colorectal cancer is gradually increasing. Common symptoms include blood in stool, increased frequency of stools, unclean bowel movements and thinning of stools. Hemorrhoids are the most common benign rectal disease, often manifested as blood in the stool, which is very similar to the symptoms of rectal cancer. In clinical practice, about 90% of rectal cancers are misdiagnosed as hemorrhoids in the initial stage. Hemorrhoids and rectal cancer are two different diseases. Hemorrhoids are caused by congestion and stagnation of veins in the lower rectum and anal canal, resulting in enlargement and varicose veins, forming a venous mass commonly known as “hemorrhoids”, which can be divided into internal and external hemorrhoids according to their location. Internal hemorrhoids occur inside the anus and cannot be seen from the body surface; external hemorrhoids occur in the skin around the anus and can be seen directly around the anus by the naked eye or can be touched by yourself. Blood in the stool is the most common symptom of hemorrhoids. Rectal cancer is a malignant tumor that occurs in the rectum and can be life-threatening if not diagnosed and treated early. Because hemorrhoids and rectal cancer have similar sites of development and the most common symptom is blood in the stool, clinical diagnosis is often confused when some symptoms cross or are atypical. Especially when the two diseases coexist, after the examination reveals the presence of hemorrhoids, it is limited to the treatment of hemorrhoids, which may delay the treatment of rectal cancer. So, what are the differences between hemorrhoids and rectal cancer? Hemorrhoid patients have blood in their stool, and it is usually “passive” bleeding. This is because the stool grazes the affected area of the hemorrhoid when defecating, and most of the blood drips down with the stool, so it does not mix with the stool, and there is no mucus, so it is usually blood on the surface of the stool and blood on the hand paper after the stool, and the color of the blood in the stool is mostly bright red. However, the bleeding of rectal cancer is “active” bleeding, which is due to the surface of the tumor itself breaking down and continuously bleeding or oozing blood. Since rectal cancer is often located higher than internal hemorrhoids, when stool is stored in the rectum, it will mix with rectal cancer bleeding, resulting in blood in the stool. It can be seen that blood in the stool of rectal cancer is old bleeding, so the color of blood is mostly dark red or jam color, and even the blood in the stool turns black after a long time. At the same time, because rectal cancer destroys the rectal mucosa and produces mucus secretion, as well as secondary local infection with pus, so the stool itself will also carry mucus and pus, the latter is also known as pus and blood stool. 2, the accompanying symptoms are different hemorrhoids are varicose veins, so blood in the stool is mostly painless, intermittent, and sometimes there is a mass (vein mass) from the anus prolapse. For prolapsed hemorrhoids, finger pressure is soft and, like veins in other parts of the body, can be squashed, or pushed back into the anus. If an internal hemorrhoid prolapses for a long period of time, it can become painful and hard, due to the formation of a blood clot within the varicose vein mass. Rectal cancer as a solid tumor with fixed location and hard texture will lead to stiffness and pressure on the rectal wall, resulting in more frequent stools, anal swelling, and bowel movements shortly after defecation, but no or only a small amount of feces is discharged. If it grows further, it may lead to narrowing of the rectal lumen and even partial blockage of the rectum, resulting in difficulty in passing stools and thinning of stools, etc. A few patients may also have abdominal pain and bloating due to rectal obstruction. Rectal finger examination Rectal finger examination is the easiest and most effective way to distinguish between the two diseases. The initial diagnosis can be made by touching the mucous membrane around the rectum with the finger. Generally speaking, rectal finger examination can detect more than 75% of rectal cancer and is a common screening tool. However, tumors in the upper rectum are often difficult to reach due to the length of the doctor’s finger, and colonoscopy can be performed when necessary. Colonoscopy is a thin light microscope that penetrates deep into the intestine and transmits the inside of the intestine to a monitor for the doctor to detect tumors with the naked eye under direct vision and make a preliminary diagnosis of the nature of the tumor. Along with colonoscopy, specimen sampling of the tumor, i.e. biopsy, can be performed, and the diagnosis of rectal cancer can be confirmed through pathological examination. Colonoscopy can detect almost all colorectal cancers, so it is called the “golden eye” to detect colorectal cancer.