Considerable progress has been made in the study of colorectal cancer in various disciplines. However, the incidence and mortality rates of colorectal cancer worldwide are still soaring, with 1.2 million new cases and 608,700 deaths in 2008, up 17.3% and 6.6%, respectively, from 1.023 million and 529,000 in 2002, i.e., an average annual increase of 2.9% in new colorectal cancer cases and 1.1% in deaths over the six-year period. The mortality rate of colorectal cancer in the 1990s increased by 28.2% compared with that in the 1970s, ranking 5th in cancer mortality; in 2005, the mortality rate of colorectal cancer increased by 70.7% compared with that in 1991, i.e. an average annual increase of 4.71%. In particular, the annual incidence rate of colorectal cancer in China’s large cities is increasing at a rate higher than the global average annual rate of increase. In the past 10 years, the incidence rate of colorectal cancer in Shanghai has increased by 5% and 5.1% per year for men and women respectively, and the mortality rate has increased by 5.3% and 4.7% respectively; the incidence rate of colorectal cancer in Beijing has increased by 5% and 4% per year for men and women respectively, and the mortality rate has increased by 3.5% and 1% respectively. At present, the incidence of colorectal cancer ranks the 3rd in China in terms of cancer incidence and the 5th in terms of mortality. The number of colorectal cancer cases accounts for 10% of all cancer cases and 8% of all cancer deaths each year. At present, the treatment of colorectal cancer is mostly multidisciplinary, but the communication among various disciplines is still insufficient, and there is a lack of global consideration on the process of development, diagnosis, treatment and rehabilitation of colorectal cancer, so the concept of full management of prevention, treatment and rehabilitation of colorectal cancer should be put forward, with the aim of enabling medical personnel engaged in the prevention and treatment of colorectal cancer to have a global concept of colorectal cancer from prevention to diagnosis, treatment and rehabilitation. Based on this, we have developed a full management program for colorectal cancer in order to further control colorectal cancer, improve diagnosis and treatment, improve patients’ quality of life, and also improve the level of treatment performance. The core content of the total management of colorectal cancer is to grasp its occurrence and development, based on screening, early detection, early diagnosis and removal of precancerous lesions, relying on the multidisciplinary team to implement the most appropriate diagnosis and treatment and good rehabilitation treatment, in order to achieve the best results and better quality of life. Colorectal cancer is a cancer that can be prevented and treated, which is best illustrated by the epidemic trend of colorectal cancer in the United States. After decades of rapid increase in the incidence and mortality rate of colorectal cancer in the United States, the trend of decline began in the mid-1980s. According to statistics, the incidence of colorectal cancer in the United States decreased by 1.9% per year from 1990 to 1994, and the incidence of colorectal cancer in men and women decreased by 3% and 2.2% per year, respectively, from 1998 to 2006, and the mortality rate in men and women decreased by 3.9% and 3.4% per year, respectively. The decline in colorectal cancer incidence and mortality in the United States can be attributed to improvements in preventive screening, elimination of causative risk factors, and treatment. Colorectal cancer mostly starts with adenoma and has a long progression. Early detection of precancerous lesions (adenoma, familial adenomatous polyposis, ulcerative colitis, etc.) can effectively prevent the development of cancer. In addition, there are more studies on the causative factors of colorectal cancer, which also provide a basis for prevention. Patients with early colorectal cancer are treated well, and 90% of them can achieve a cure. At present, the goal of controlling colorectal cancer epidemic is “less incidence and easier to cure”, and screening is the most important tool. Screening can eliminate precancerous lesions and reduce the occurrence of cancer; screening can achieve the “three early stages” (early detection, early diagnosis and early treatment). Data from the United States show that screening is not recommended for people under 50 years of age, but the incidence of colorectal cancer has increased by 2% per year since 1994. A randomized trial in the United Kingdom showed that one-time fiberoptic sigmoidoscopic screening in people aged 55 to 65 years reduced the incidence of colorectal cancer by 33% and mortality by 43%. This shows that screening not only reduces the occurrence of colorectal cancer, but also enables early diagnosis and treatment of colorectal cancer patients. From 2010 to 2012, more than 460,000 people were screened, and 1,455 cases of colorectal cancer were detected, with an early diagnosis rate of nearly 90%, and most of the patients were treated in time. At the same time of colorectal cancer screening, health education on cancer prevention should be conducted to make people consciously choose a healthy lifestyle, arrange diet (balanced diet), avoid “three highs and one low” (high fat, high protein, high energy, low fiber); actively participate in physical exercise, quit smoking and control alcohol, control weight and prevent obesity; actively participate in Active participation in screening and timely treatment of precancerous lesions. Early symptoms of colorectal cancer are not obvious and can be easily ignored by patients or doctors, thus losing the opportunity to cure. Therefore, patients above 20 years old with the following symptoms: (1) recent persistent abdominal discomfort, vague pain, gas and distension; (2) change in stool habit, constipation or diarrhea or both; (3) blood in stool; (4) unexplained anemia or weight loss; (5) abdominal mass, etc. should consider the possibility of colorectal cancer and conduct physical examination, paying special attention to rectal finger examination, which is simple and easy to perform, but of high value. The value of this examination is very high. More than 80% of rectal cancer patients in China can be detected by rectal finger examination. In addition to the three routine tests, fecal occult blood test, liver and kidney function, blood lipid, blood sugar and tumor markers (CEA, CAl99) should be routinely detected. Imaging examinations include ultrasound imaging (endorectal ultrasound, endoscopic ultrasound or ultrasonography), CT, magnetic resonance imaging (MRI) and barium enema x-ray, and sometimes positron emission computed tomography (PET-CT) is required. Of course, the final confirmation of diagnosis relies on endoscopy, in which photographs, biopsies, and brush smears for pathological cytology are taken. For colorectal cancer, pathological diagnosis alone is not sufficient to help guide treatment. The correct diagnosis should be a clinicopathological diagnosis plus TNM staging and molecular staging. The current 2010 American Joint Committee on Cancer (AJCC) and International Union Against Cancer (UICC) TNM staging system for colorectal cancer, 7th edition, is more detailed than before, with stage T4 divided into T4a and T4b, stage N1 divided into N1a, N1b and N1c, stage N2 divided into N2a and N2b, and stage M1 divided into M1a and M1b. The prognosis of some stage IIB patients is worse than that of stage IIIA. Therefore, it is necessary to subdivide them at the molecular level, however, there is no universal molecular typing yet, more around genetic factors to detect microsatellite instability status (MSI) and/or mismatch repair protein (MMR). Recent studies have shown that hMLHl, hMLH2, hpMSl, hpMS2, hMSH3, and GTBP/hMSH6 are associated with hereditary non-polyposis colon cancer (HNPCC). For example, testing for MMR or MSI, if dMMR or MSI-H, fluorouracil analogs alone are not appropriate as adjuvant chemotherapy for stage II colorectal cancer; testing for mutations in the K-ras gene can help in the selection of targeted drugs (cetuximab); testing for Osteopantin (OPN) and Sparcll can predict liver metastasis from colorectal cancer The detection of Osteopantin (OPN) and Sparcll can predict colorectal cancer liver metastasis. 3.Integrated multidisciplinary treatment In the past 30 years, the treatment of colorectal cancer has moved from single surgery to integrated multidisciplinary treatment, and achieved obvious results. (1) To implement multidisciplinary comprehensive treatment, a multidisciplinary expert team must be established first: the multidisciplinary expert team includes experts in gastrointestinal oncology surgery, medical oncology, hepatobiliary surgery, imaging, pathology, radiotherapy, intervention and specialized nursing. A relevant system should be established, with regular schedule, location and personnel (“three fixes”), in a conference room with relevant equipment, to conduct comprehensive assessment of each colorectal cancer patient before initial treatment and formulate a reasonable treatment plan. (2) Individualized treatment under the premise of standardized treatment: In 2010, the Medical Secretary of the Ministry of Health published the “Colorectal Cancer Treatment Standards”, the NCCN Clinical Practice Guidelines for Colorectal Cancer are published annually in the United States, and the ESMO Clinical Consensus Guidelines were published in Europe in 2012, which are the basis for standardized treatment. Multidisciplinary experts should clarify the treatment purpose (curative or palliative, radical or decompensated surgery) and disease stage according to the patient’s physical condition, tumor status and medical conditions, and classify patients for treatment, especially for patients with distant metastases (liver metastases, lung metastases or multiple metastases). For example, for patients with colorectal cancer with multiple liver metastases, multidisciplinary experts are needed to evaluate whether the liver metastases can be resected by R0, which is the key to patient classification. For patients with R0 resectable colorectal cancer, surgical resection combined with perioperative chemotherapy is used to maximize the efficacy; for patients with temporarily unresectable colorectal cancer that is expected to be converted to resectable through chemotherapy, close cooperation among multidisciplinary experts is the guarantee to maximize the conversion rate; for patients with unresectable colorectal cancer, chemotherapy, interventional, biological therapy and symptomatic support therapy are used to For patients with unresectable colorectal cancer, chemotherapy, interventional, biological treatment and symptomatic support therapy are used to control tumors, reduce symptoms and prolong patients’ survival. In addition to the classification and standardization of treatment, there is also the issue of individualized treatment for the same type of patients. Take patients with colorectal cancer liver metastases that can be resected with R0 as an example, there are also differences between simultaneous resection of primary and liver metastases or staged resection, resection of primary foci first (traditional style) or resection of metastases first (inverted style), immediate resection or resection after neoadjuvant chemotherapy, and so on, depending on the specific conditions of the patients, individualized treatment is required. (3) The use of adjuvant chemotherapy and neoadjuvant therapy: Research in the late 1980s showed that adjuvant chemotherapy with fluorouracil (5-Fu) could improve the 5-year survival rate of stage III colon cancer patients after surgery, thus formally establishing adjuvant chemotherapy as an important part of colorectal cancer treatment and bringing colorectal cancer treatment from the era of single surgery into the era of comprehensive treatment. With the introduction of capecitabine and oxaliplatin, as well as the application of FOLFOX regimen (5.Fu + calcium formyl tetrahydrofolate + oxaliplatin) and XELOX regimen (oxaliplatin + capecitabine), etc., the efficacy of adjuvant chemotherapy has been significantly improved, and adjuvant chemotherapy for colorectal cancer has become a model for standardized tumor treatment. The first milestone in the treatment of rectal cancer was the first successful transabdominal perineal colectomy of rectal cancer by British doctor Miles in 1907, which announced the possibility of surgical cure for rectal cancer. In 1982, Heald, a British doctor, advocated total mesorectal excision (TME), which reduced the local recurrence rate to less than 10%, and was therefore regarded as the second milestone in the surgical treatment of rectal cancer and the current gold standard for rectal cancer surgery. In order to further reduce the local recurrence rate and increase the rate of anal preservation, neoadjuvant therapy (i.e., preoperative radiotherapy) for rectal cancer patients has been emphasized and promoted. A randomized clinical trial in the Netherlands showed that preoperative radiotherapy plus total mesorectal resection for rectal cancer was significantly better than total mesorectal resection alone, with local recurrence rates of 2% and 8%, respectively. A large prospective randomized controlled clinical trial conducted by the French Rectal Cancer Study Group showed that preoperative radiotherapy significantly reduced the 3-year local recurrence rate compared with postoperative radiotherapy (4.4% versus 10.6%, P<0.0001). Although there is a consensus on preoperative radiotherapy for rectal cancer, the specific radiotherapy regimen (dose, duration, frequency), chemotherapy regimen (drug, dose, route of administration), the interval between surgery after radiotherapy, and whether to reduce the scope of surgery due to complete pathological remission (pcr) with preoperative adjuvant radiotherapy are still much controversial and should be discussed and decided by multidisciplinary experts. < p=""> (4) Translational therapy: The concept of translational medicine was introduced in the mid-1990s, which encompasses the transition from laboratory to clinical (i.e., basic research to preclinical or clinical research), or from evidence-based to applied outreach. For colorectal cancer treatment, unresectable or potentially resectable liver or lung or simultaneous liver-lung metastases are converted to resectable after the application of chemotherapeutic approaches. The resection rate of liver metastases from colorectal cancer is only 10%-20%, but after conversion therapy, its resection rate increases to more than 30%. The application of conversion therapy cannot be separated from targeted drugs and chemotherapy regimens, and when choosing targeted drugs cetuximab or bevacizumab, the mutation of K-ras gene should be tested, and cetuximab is only applicable to patients with K-ras wild type of colorectal cancer. For patients with advanced disease who have no chance of transformation, they should be treated under the concept of “three-drug principle, overall planning and treatment maintenance” to ensure their quality of life and extend their survival time as long as possible. 4. Rehabilitation treatment Colorectal cancer treatment should include postoperative rehabilitation treatment. Colorectal cancer patients, after undergoing arduous surgery, chemotherapy and/or radiotherapy and other comprehensive treatments, have suffered serious physical and psychological blows, not only their physical functions are damaged, but also psychological pessimism and disappointment, depression, anxiety and fear, or even suicidal thoughts, which are in urgent need of guidance from medical and nursing staff. After the comprehensive treatment of colorectal cancer patients mainly by surgery, bowel function (frequent stool, constipation, incontinence), urinary function (painful urination, frequent urination, incontinence or urinary retention, etc.), sexual function (impotence, inability to ejaculate, sexual apathy, etc.) and stoma complications (stoma prolapse, retraction, para-stoma hernia, peristomal inflammation, bleeding, edema, necrosis, etc.) all affect patients’ normal life and need to be handled carefully by medical and nursing staff. Patients’ negative emotions change a lot during the whole course of the disease. Studies have shown that cancer patients generally have psychological disorders such as depression, anxiety and despair, and the heavier the negative emotion, the shorter the survival time; and because patients have obvious psychological problems after cancer, the quality of life (physical function, psychological function, social function, etc.) is obviously reduced, therefore, psychological counseling is very important throughout the whole process. After surgery, cancer patients should follow a healthy lifestyle, balanced diet, appropriate exercise or physical activity, quit smoking and alcohol control, maintain body weight and prevent obesity, which can help reduce tumor recurrence and metastasis and is an alternative, non-drug adjuvant therapy that can lead to a better prognosis for patients. 5.Quality of life assessment and follow-up Colorectal cancer patients should fill in or answer the questions on the quality of life form after treatment in order to assess the quality of life of patients. Regular follow-up of colorectal cancer patients is very important. Postoperative physical examinations should be performed every 3-6 months for 2 years; then every 6 months for 5 years; and annually after 5 years. Monitor CEA and CAl99 every 3 months for 2 years; then every 6 months for 5 years; and once a year after 5 years. Abdominal and pelvic ultrasound and chest radiography every 3 to 6 months for 2 years; then every 6 months for 5 years; and once a year after 5 years. CT or MRI of the abdomen and pelvis once a year for a total of 5 years; then once a year after 5 years. Colonoscopy within 1 year after surgery, if there is any abnormality, review in 1 year; if no polyp is seen, review in 3 years; then once in 5 years, any colorectal adenoma detected by follow-up examination should be removed and biopsied. In summary, the whole management of colorectal cancer patients focuses on prevention forward and emphasizes screening for colorectal cancer. In fact, more than 1.5 million people were initially screened in China from 2010 to 2013, and more than 3,700 cases of colorectal cancer were detected, with early diagnosis and timely treatment rates reaching as high as 90%. The experiences of Tianjin, Shanghai and Haining City show that this popular and livelihood project can be done well with government-led, health administrative department organization, active action of medical personnel and mobilization of the whole society. The core of total management is to emphasize the formation of multidisciplinary expert teams, the implementation of multidisciplinary standardized treatment, the monitoring of the whole process before, during and after treatment, as well as rehabilitation guidance and quality assessment. Total management is not only based on better treatment of patients, but also on better control of colorectal cancer, stopping its rising trend and changing “two highs and one low” (high morbidity, high mortality and low survival rate) to “two lows and one high” (low morbidity, low mortality and high survival rate). (low incidence rate, low mortality rate, high survival rate).