Six hundred and forty-five patients presenting with colorectal cancer over a 6-year period were studied prospectively. At the time of presentation almost half the patients had clinical evidence of local tumour fixity and over one-quarter had distant metastases. The overall resectability rate was 70.8 per cent, apparently curative resection being obtained in 52.5 per cent. Overall operative mortality rate was 13.8 per cent, increasing in the elderly. Approximately 70 per cent of patients undergoing 'curative' resections survived for 2 years, 50 per cent survived for 5 years and 40 per cent survived for 10 years. After palliative resection approximately 10 per cent of patients survived for 5 years; only six of 133 patients (4 per cent) undergoing palliative diversion survived for 2 years. This prospective study confirms the advanced stage of colorectal cancer as it presents to a non-specialist centre. Although the poor outlook is largely a consequence of the advanced nature of the disease, there is evidence to suggest that the results of surgical intervention could be improved.