《中国恶性肿瘤整合诊治指南-直肠癌（2024 版）》充分参考了国内外最新研究成果，整合相关领域专家意见，形成了更新版本。流行病学部分，根据国家癌症中心最新研究数据，更新了结直肠癌的发病率、死亡率等详细数据。筛查部分，将一般人群筛查起始年龄更改为45 岁。外科部分，补充了全结肠系膜切除术、经自然腔道取标本手术、“机器人”手术及经肛门全直肠系膜切除术的循证医学证据。内科部分，增加了免疫治疗的循证医学证据，推荐dMMR/MSI-H 的患者可考虑免疫治疗；基于最新研究结果更新了Ⅱ期高危和Ⅲ期低危患者化疗周期。放疗部分，对术前新辅助放化疗的原则进行细化重置，根据肿瘤分期、微卫星状态、保肛意愿等制定不同方案，并对直肠癌放化疗联合原则和直肠癌放化疗后手术时机进行了内容更新。中医药部分将“辨证施治原则”调整为“辨病论治与辨证施治相结合的原则”，增加了直肠癌防变治疗期辨证施治内容，并增加了中医非药物疗法的应用。

CACA guidelines for holistic integrative management of rectal cancer （2024 Edition）fully refers to the latest researches at home and abroad， integrates experts' opinions in relevant fields and forms an updated version.In the epidemiology section， according to the latest data of the National Cancer Center， the detailed data of incidence and mortality of colorectal cancer were updated.In the screening section， the beginning age for general population screening has changed to 45 years old.In the surgical section， novel evidences have been added to total mesocolectomy， natural orifice specimen extraction surgery， “robotic” surgery and transanal total mesorectal excision.In the internal medicine section， novel evidences have been added to immunotherapy， and it is recommended that patients with dMMR/MSI-H status can consider immunotherapy.Besides， based on the latest researches， the chemotherapy cycles for high-risk stage Ⅱ patients and low-risk stage Ⅲ patients have been updated.In the radiotherapy section， the principles of preoperative neoadjuvant chemoradio-therapy were refined and reset， and different plans were developed based on tumor staging， microsatellite status and anal preservation intention.The principles of combined chemoradiotherapy for rectal cancer and the opportunity of surgery after chemoradiotherapy were also updated.In the traditional Chinese medicine section， the principle of “treatment based on syndrome differentiation” has been changed to “the combination of treatment based on disease differentiation and treatment based on syndrome differentiation”.At last， the current edition have added “treatment based on syndrome differentiation during rectal cancer follow-up period” section and the application of nonpharmacological therapies in traditional Chinese medicine.