Hemorrhoids usually have blood on the surface of stool and blood on the hand paper after stool, and the color of blood in stool is mostly bright red. The blood in stool of rectal cancer is stale bleeding, and the blood is mostly dark red or jam-colored. The simplest and most effective way is to conduct rectal finger test. With the increase of high protein and high fat food intake of Chinese residents, the incidence rate of colorectal cancer is gradually rising. Common symptoms include blood in the stool, increased frequency of bowel movements, impure bowel movements, and thinning of the stool. Hemorrhoids are the most common benign rectal disease, often manifested as blood in stool, which is very similar to the symptoms of rectal cancer. In clinical practice, about 90% of rectal cancers are misdiagnosed as hemorrhoids at the initial stage. Hemorrhoids and rectal cancer are two different diseases. Hemorrhoids are caused by congestion and stagnation of veins in the lower part of rectum and anal canal, which results in enlargement and varicose veins, forming vein clusters, commonly known as “hemorrhoids”, which can be classified into two types according to the place of occurrence: internal hemorrhoids and external hemorrhoids. Internal hemorrhoids occur in the anus, from the body surface can not be seen; external hemorrhoids occur in the skin around the anus, can be directly around the anus through the naked eye to see or can be touched. 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. Since hemorrhoids and rectal cancer have similar sites of development and the most common symptom is blood in stool, clinical diagnosis is often confused when some symptoms cross or are atypical. Especially when the two diseases coexist, the examination found hemorrhoids, then confined to the treatment of hemorrhoids, there may be a delay in the treatment of rectal cancer. Then, what are the differences between hemorrhoids and rectal cancer? First of all, the characteristics of blood in stool are different. Hemorrhoids patients have blood in stool, usually “passive” bleeding. This is due to the fact that when defecation occurs, the stool wounds the hemorrhoidal area, and most of the blood drips down with the stool, therefore, it does not mix with the feces, and there is no mucus, therefore, it is usually blood on the surface of the stool, and blood on the handkerchiefs after defecation, and the color of blood in the stool is mostly bright red. However, the bleeding of rectal cancer is “active” bleeding, which is because the tumor itself breaks down on the surface and bleeds or oozes blood continuously. Since rectal cancer is often located higher than internal hemorrhoids, when the stool is stored in the rectum, it will be mixed with the bleeding from rectal cancer, resulting in blood mixed in the stool. It can be seen that blood in stool of rectal cancer is old bleeding, so the color of blood is mostly dark red or jam color, and the blood inside stool even turns black after a long time. Meanwhile, because rectal cancer destroys rectal mucosa and produces mucus secretion, as well as secondary local infection and pus flow, so the stool itself also carries mucus and pus, and the latter is also called pus-blood stool. Secondly, the accompanying symptoms are different. Hemorrhoids are varicose vein clusters, so the blood in the stool is mostly painless, intermittent, and sometimes there are lumps (vein clusters) prolapsed from the anus. For prolapsed hemorrhoids, they are soft when pressed with a finger, and like veins in other parts of the body, they can be flattened or pushed back into the anus. If internal hemorrhoids prolong prolapse, pain and hardness can occur, due to the formation of blood clots within the varicose vein mass. Rectal cancer, as a solid tumor with a fixed location and hard texture, will lead to stiffness and pressure on the rectal wall, resulting in more frequent bowel movements, anal cramps, and the urge to have a bowel movement soon after defecation, but no fecal discharge or only a small amount of fecal discharge. If the disease grows further, it may lead to narrowing of the lumen of the rectum or even partial blockage of the rectum, which may cause difficulty in passing stools and thinning of stools, etc. A few patients may also suffer from abdominal pain and bloating due to rectal obstruction. Rectal finger test is the simplest and most effective way to distinguish between the two diseases. The initial diagnosis can be made by touching the mucosa around the rectum with the finger. Generally speaking, rectal finger test can detect more than 75% of rectal cancers and is a commonly used screening tool. However, due to the limitation of the length of the doctor’s finger, it is often difficult to detect the tumor at the upper end of the rectum, and colonoscopy can be performed if necessary. Colonoscopy is a thin light microscope that penetrates deep into the intestines and transmits the inside of the intestines to a monitor for the doctor to detect the tumor under direct vision with the naked eye and make a preliminary diagnosis of the nature of the tumor. At the same time as 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.