The occurrence of colorectal tumors is very closely related to age. Due to the fear of the risk of colonoscopy, many people are reluctant to undergo regular colorectal cancer screening, especially the elderly, so many elderly colon tumor patients are seen only after the tumor is relatively large and there is significant obstruction or bleeding. The question of whether to operate or not becomes a very difficult one to decide when the long-term effect of risky treatment is not well predicted with higher age and more severe disease. 1. Expected target and tumor stage: If the tumor stage is okay and complete resection is possible, the prognosis of colorectal cancer is mostly good and surgery is generally recommended. If the tumor has extensive metastasis, the general long-term effect is poor, and some conservative treatment is recommended. However, in case of obstruction and severe bleeding, some surgery to relieve symptoms, such as rerouting surgery, can be done. In the case of single obstruction, stenting under colonoscopy can also be used. The treatment of colorectal cancer liver metastasis has made great progress in recent years, and this content will not be further described in this paper. 2.Safety of treatment: Colorectal cancer surgery is relatively safe, and it is common to have colorectal cancer surgery in 80s. Laparoscopic surgery has the advantage of minimally invasive, and the effect of treating colorectal cancer is also supported by large sample studies in some countries with high incidence and highest treatment level of colorectal cancer, such as the United States, Japan and the United Kingdom. However, for the elderly, the risks of even minimally invasive surgery should be highly valued. Coronary heart disease, hypertension, chronic bronchitis and diabetes are the most common comorbidities in the elderly, and whether they can tolerate the surgery requires consultation with doctors from related departments and anesthesiologists together. 3. Postoperative adjuvant therapy: For elderly people over 70 years old, routine postoperative chemotherapy is generally not recommended. In recent years, some chemotherapy regimens based on oral preparations of 5-FU prodrugs have been gradually increasing in the elderly. In order to clarify how to treat the most reasonable, more detailed preoperative examination indicators are necessary. Many people always think that once a tumor is identified, it should be operated as soon as possible, so why do so many tests? In fact, not every tumor case is suitable for surgery, or suitable for early surgery. For those cases that should be operated, the choice of surgery method needs more detailed examination. It is the unreasonable treatment that will be more time consuming and costly. This can be referred to the typical case I wrote – CT and colonoscopy are done, why do you need ultrasound endoscopy?! If forwarding, please credit the original as Dr. Kai-Lin Cai, Chief of Gastrointestinal Surgery and Minimally Invasive Surgery, Union Hospital of Huazhong University of Science and Technology.