Cancer patients constitute a risk group for colorectal cancer (CRC). At the moment, the problem of developing recommendations for the early diagnosis of CRC in the group of patients with extracolorectal malignancies remains unresolved. OBJECTIVE: to identify ways to optimize the organization of diagnostics of secondary metachronous primary multiple CRC in patients with primary extracolorectal malignancies. METHODS: The medical documentation of 163 cancer patients registered at the «Kursk Oncology Research and Clinical Center named after G.E. Ostroverkhov» from 2018 to 2022 is analyzed. Inclusion criteria are presence of morphologically verified cancer of extracolorectal localization, secondary detection and histological verification of colorectal cancer, the interval between diagnosis of cancer is more than 6 months. The features of the distribution of observations into subgroups identified according to the profile of dispensary observation are separately studied. Statistically, the data is processed using the IBM SPSS Statistic 20.0 program. RESULTS: Patients aged 70 years or older and more women suffer. The tumor mainly affects the left parts of the colon, a large proportion of stage 1, a small proportion of stage 4. Most often, secondary metachronous CRC is diagnosed in patients undergoing oncodermatological observation, urology and female reproductive care. CRC is diagnosed earlier among patients with skin and urological tumors, and later among patients with breast cancer and gynecological oncology. There is an increase in the number of cases of secondary metachronous CRC diagnosed per year, however, secondary metachronous CRC in the analyzed group was diagnosed in a third of cases at stage III, there is a high probability of detecting tumor and precancerous pathology in patients at the stage of diagnosis of primary cancer. CONCLUSION: the solution to the problem of early diagnosis of CRC in the group of patients with extracolorectal malignancies is to add immunochemical testing of feces for occult blood to the examination algorithm.