Colon and rectal cancer is one of the leading causes of cancer death worldwide. Several areas of uncertainty remain in the screening and treatment of this disease, even though significant advances have already led to decreased rates of incidence and mortality over the last several decades. This review addresses some of the current controversies in screening for and the treatment of colorectal cancer, including specifically looking at issues related to screening modalities, local versus radical resections, protocols for adjuvant therapy and the treatment of stage IV disease.