T HE INCIDENCE and mortality rate of cancer of the colon and rectum is second only to that of lung cancer. Approximately 140,000 people in the United States are diagnosed with colon and rectal cancer annually.’ More than 60,000 people die from this disease each year. The incidence of colorectal cancers increases with age, with 94% of all cases occurring after the age of 50. Despite the great numbers of people that are diagnosed with or die from colon and rectal cancer each year, the public is surprisingly unaware of the facts concerning colorectal cancer. Warning signals of early, treatable, curable cancer often go unnoticed or ignored. Holliday and Hardcastle found in a retrospective study of 200 patients with colorectal cancers in England that an average lag time from symptoms to diagnosis was 8.25 months.2 Part of the delay was due to the patient and part to the family physician. Holland identified specific reasons for delays in seeking treatment as ignorance, denial of painful information, fear of mutilation and death, excessive modesty, and prior psychiatric illness.3 The results of a national American Cancer Society (ACS) study on colorectal cancers found that the public erroneously regarded a permanent colostomy as a normal result of colon and rectal cancer.4 Approximately 15% of patients with colorectal cancer require colostomy.5 The majority of the cancers requiring a permanent colostomy are found in the distal segment of the rectum or 0 to 5 cm above the anus. Additional indications for colostomy include when a low anastomosis is not feasible, when a wide resection for removal of the cancer would interfere with the rectal sphincters, when the cancer is a bulky, invasive, poorly differentiated midrectal cancer in an obese patient, or when the patient has a narrow pelvis making tumor resection with end-to-end anastomosis (EEA) difficult or undesirable.5